CPT 92507: Speech-Language Assessment for Communication and Hearing
Medicare pays $79 and commercial payers pay $134 on average nationally for this procedure.
CPT code 92507 describes an individual speech-language pathology service in which the provider directly interacts with a patient who has communication and hearing difficulties to assess sound production and whether auditory signals reach the brain; the service is an comprehensive speech-language assessment focused on receptive and expressive deficits and sound-making ability, typically delivered in an outpatient clinic or therapy setting and documented as a skilled, one-on-one diagnostic/treatment encounter.
For related coverage guidance, see recent payer policy updates: Office-based Laryngeal Procedures, Injectable Dermal Fillers and Bulking Agents (for New Mexico Only), Injectable Dermal Fillers and Bulking Agents (for Kentucky Only).
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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.