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    v1.0.30
    OpenPayerBilling CodesOtorhinolaryngologic Evaluation and ProceduresCPT cpt-92522-speech-sound-production-evaluation
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    CPT 92522: Speech Sound Production Evaluation

    Medicare pays $116 and commercial payers pay $211 on average nationally for this procedure.

    CPT code 92522 describes an evaluation by a speech‑language pathologist of a patient’s speech sound production, assessing articulation, phonological processes, and oral‑motor function; the service type is a speech‑language pathology diagnostic evaluation and the typical site of service is an outpatient clinic or office where the SLP examines the jaw, lips, and tongue for structure and function to identify mispronunciations and related speech sound issues.

    For related coverage guidance, see recent payer policy updates: Clinical Review Criteria Intraoperative Neurophysiological Monitoring (IONM), Remote Electrical Neuromodulation for Migraines (i.e., Nerivio®), Lumbar Microdiscectomy.

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    National Reimbursement Benchmarks

    Nationally, Medicare averages $115.60 for CPT 92522 while BUCA’s mean commercial rate is $210.80, so BUCA sits about $95.20 higher than Medicare on average, reflecting materially higher commercial reimbursement versus the federal program. Blue Cross Blue Shield and Aetna show higher mean levels than Medicare as well, while Cigna and UnitedHealth Group fall between Medicare and BUCA.

    Dispersion (P75 minus P25) highlights where rates are most and least variable: Blue Cross Blue Shield is widest with a spread of $116.60 ($325.60 - $194.00), followed by UnitedHealth Group at $95.40 ($189.30 - $98.59) and Cigna at $109.20 ($216.90 - $107.70). Aetna is the tightest among listed commercial payers with a spread of $36.20 ($113.80 - $76.00). Medicare’s interquartile spread is $8 ($118 - $110).

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    National Payer Mean Reimbursement Rates

    State Reimbursement Rates

    State: Alaska1 / 51

    Rate by payer

    Clinical & Coding Specifications

    Clinical Context

    A 58-year-old patient with a recent diagnosis of oropharyngeal cancer presents for a speech–language pathology evaluation of speech sound production following transoral robotic surgery and partial oropharyngeal resection. The referring otolaryngologist requests assessment because the patient demonstrates imprecise consonant articulation and reduced oral motor strength affecting intelligibility. The SLP obtains history, reviews recent operative and radiotherapy records, and conducts a focused oral mechanism examination of the jaw, lips, tongue, palate, and velopharyngeal function. Standardized and informal articulation probes are administered to identify error patterns (e.g., substitution, omission, distortion), and stimulability testing is performed. Findings are documented, including objective measures of articulation accuracy, oral structure/function observations, recommendations for targeted therapy versus compensatory strategies, and anticipated prognosis. The evaluation typically occurs in an outpatient clinic or cancer rehabilitation setting with the SLP credentialed under the Speech-Language Pathologist taxonomy. The visit may be billed using 92522 for evaluation of speech sound production with documentation of the oral mechanism examination and diagnostic findings. Clinical workflow includes intake and chart review, oral motor and articulation assessment (30–60 minutes), documentation of results and plan, and communication of recommendations to the surgical and oncology team.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    92507

    Related Modifiers

    8 rows

    ModifierDescriptionWhen to Use
    25CPT modifier 25 indicates that on the same day as another procedure or service, the same physician or other qualified health care professional provided a significant, separately identifiable…- When to apply: Use modifier 25 only on an E/M code to indicate the same provider delivered a significant, separately identifiable E/M service on the same day as another procedure or service — i.e.,…
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    95Modifier 95 indicates that a service was provided via synchronous, real‑time audio‑video telehealth rather than in‑person. Per CMS, AAPC and professional associations, append modifier 95 to claim…- Use modifier 95 to indicate a service was furnished via synchronous, real‑time audiovisual telehealth (a live audio‑video conference between patient and provider) rather than in‑person. - Pair…
    76Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…
    77Modifier 77 indicates that a previously performed procedure or service was legitimately repeated by a different physician or other qualified health care professional. The AMA’s CPT definition…- Use modifier 77 when a basic procedure or service already performed is repeated by a different physician or other qualified health care professional (for example, a second provider independently…
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    235Z00000X
    2355S0801X
    103TC0700X
    372500000X
    261Q00000X
    261QR0404X
    2080P0205X
    207UN0901X

    Related Payer Policy Updates

    Specialty: Neurology/Neurosurgery1 / 3

    10 rows

    PolicyPayerEffective Date
    Clinical Review Criteria Intraoperative Neurophysiological Monitoring (IONM)Kaiser Permanente2027-01-01
    Remote Electrical Neuromodulation for Migraines (i.e., Nerivio®)bcbsvermont2026-11-01
    Lumbar Microdiscectomyuniverahealthcare2026-10-15
    Artificial Cervical Intervertebral Discuniverahealthcare2026-10-15
    Lumbar Decompressionuniverahealthcare2026-10-15
    Responsive Neurostimulation for Focal EpilepsyPremera Bluecross2026-10-14
    Intraoperative MonitoringProvidence Health Plan2026-10-01
    Intraoperative MonitoringProvidence Health Plan2026-10-01
    High-Intensity Focused UltrasoundMass General Brigham Health Plan2026-10-01
    Vagal Nerve StimulationAmbetter Nevada2026-10-01

    Related Codes

    CPT-92520-VOICE-LARYNGEAL-FUNCTION-TESTING

    CPT 92520: Laryngeal Function and Voice Assessment

    CPT-92521-SPEECH-FLUENCY-EVALUATION

    CPT 92521: Speech Fluency Evaluation by SLP

    CPT-92523-SPEECH-SOUND-PRODUCTION-EVALUATION

    CPT 92523: Speech Sound Production Evaluation

    CPT-92524-VOICE-QUALITY-NASALITY-VOCAL-BEHAVIOR-EVALUATION

    CPT 92524: Evaluation of Voice Quality, Nasality, and Vocal Behavior

    CPT-92526-DYSPHAGIA-EVALUATION-AND-TREATMENT

    CPT 92526: Evaluation and Treatment of Swallowing Disorder

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
    Published by

    Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Treatment of speech, language, voice, communication, and/or auditory processing disorder
    Follows 92522 when individualized therapy is initiated based on evaluation findings.
    92508Group therapy for speech‑language pathology (when not direct one‑on‑one contact)Used when subsequent treatment from the 92522 evaluation is delivered in a group format.
    92521Evaluation of speech fluency (eg, stuttering, cluttering)Performed when fluency disorders are also a concern; may be billed in addition to 92522 if distinct.
    92523Evaluation of speech sound production; with evaluation of language comprehension and expressionBroader evaluation that includes both speech sound production and language — may be chosen instead of or in addition to 92522 depending on scope.
    92524Behavioral and qualitative analysis of voice and resonanceComplementary when voice or resonance issues are present after oropharyngeal surgery and require assessment beyond articulation testing.