Summary & Overview
CPT 92555: Speech Reception/Awareness Threshold Measurement
CPT code 92555 documents measurement of a patient’s speech reception/awareness threshold — the lowest volume at which speech is recognized. This diagnostic audiology code is central to evaluating hearing function, guiding clinical management, and informing medical necessity determinations for hearing-related services and devices. Nationally, it matters because it directly impacts coverage decisions, prior authorization workflows, and coding compliance across payers.
Key payers covered in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of typical billing contexts for 92555, including clinical indications and common sites of service, plus benchmarks and payer coverage patterns where available. The publication summarizes reimbursement considerations, documentation expectations, and common modifiers used with audiology diagnostic services.
This summary provides clinicians, billing staff, and policy analysts with concise clinical context, payer breadth, and topics to review further: coding specificity for speech reception testing, how 92555 integrates into diagnostic test panels, and policy drivers that influence coverage. Data not available in the input will be identified in relevant sections.
Billing Code Overview
CPT code 92555 measures a patient’s speech reception/awareness threshold, defined as the lowest volume at which the patient can recognize speech. This evaluation quantifies speech recognition ability and is used to assess auditory function related to hearing and communication performance.
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Service type: Diagnostic audiology assessment
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Typical site of service: Audiology clinic or outpatient otolaryngology/ear, nose, and throat (ENT) setting
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Clinical & Coding Specifications
Clinical Context
A typical patient is an adult or pediatric outpatient referred to audiology by a primary care physician or otolaryngologist for evaluation of hearing difficulty, suspected hearing loss, or follow-up after ear surgery. The patient presents to a hospital outpatient clinic, freestanding audiology clinic, or ENT office. The audiologist or qualified provider administers speech reception/awareness threshold testing (92555) in a sound-treated booth using recorded or monitored live voice materials to determine the lowest level at which the patient can recognize or be aware of speech. Results inform decisions about hearing aid candidacy, medical evaluation, or cochlear implant referral. The workflow includes patient history review, otoscopic inspection, tympanometry as needed, pure tone air and bone conduction thresholds, and then speech reception testing. Documentation includes test method, ear tested, stimulus type, level increments, patient responses, environmental conditions, and interpretation linking results to the treatment plan.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when reporting only the interpretation and report by the professional audiologist/physician separate from technical test administration. |