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CPT 92507: Speech and Hearing Diagnostic Evaluation
CPT code 92507 covers a diagnostic evaluation delivered by a speech-language pathologist or clinician who directly interacts with a patient to assess speech production and language comprehension. The service identifies impairments in sound production and evaluates whether auditory signals reach the brain, making it central to diagnosing conditions such as phonological disorders, expressive or receptive language deficits, apraxia, and aphasia. Nationally, this code is important for care pathways that connect diagnostic assessment to therapy, educational services, and audiology referrals.
Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, United Healthcare, and Medicare. Readers will find clinical context for the code, typical settings where the service is delivered, related diagnostic scenarios, and how this code fits with adjacent evaluation and treatment codes used in speech-language pathology and audiology services.
The publication provides benchmarks and operational guidance for coding combinations and service workflows, clarifies clinical scenarios where 92507 is applicable, and highlights related evaluation codes to help clinicians and billing staff align documentation with billing practice. Data not available in the input is noted where applicable.
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Billing Code Overview
CPT code 92507 describes a diagnostic speech and hearing evaluation in which the provider directly interacts with a patient who has communication and hearing difficulties. The assessment focuses on the patients ability to produce sounds and on receptive and expressive language deficits to determine whether acoustic signals are reaching the brain via the ears.
Service Type: Speech-language pathology assessment / audiology-related diagnostic evaluation
Typical Site of Service: Outpatient clinic, speech-language pathology practice, or audiology clinic
National Reimbursement Benchmarks
Medicare’s mean rate of $78.8 for CPT 92507 sits well below the BUCA commercial average of $133.9, indicating a substantial gap between public and broad commercial reimbursements for this code. That gap of $55.1 highlights the different valuation tiers payers place on this service, with Medicare clustered tightly around the high $70s while BUCA centers in the low $130s.
Dispersion varies notably: Blue Cross Blue Shield shows one of the widest interquartile spreads with P75–P25 = $72.1, while Aetna’s spread is $63.4 and UnitedHealth Group’s is $70.6, indicating broader variability among those commercial contracts. Cigna’s spread is $77.9, the largest among listed payers, and BUCA’s IQR is $76.6; Medicare is the tightest with P75–P25 = $5.