Summary & Overview
CPT 92605: Evaluation for Non–Speech–Generating Communication Device, 1 Hour
CPT code 92605 represents a comprehensive, face-to-face evaluation (one hour) to assess a patient’s abilities and determine the most suitable non–speech–generating communication device, with caregiver input incorporated into the assessment. This code is significant nationally as it documents a specialized allied-health service—commonly delivered by speech-language pathologists—that facilitates functional communication for patients with severe expressive limitations. Proper use of CPT code 92605 can affect device selection, care planning, and downstream durable medical equipment decisions.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication presents what stakeholders need to know about coverage patterns, billing practice benchmarks, programmatic policy considerations, and the clinical context for AAC device evaluations. Readers will find national benchmarks for utilization and payment where available, summaries of payer policy trends that influence coverage of comprehensive AAC assessments, and practical clinical context about service delivery and typical settings. Where specific input was not provided, the report notes Data not available in the input. The content is intended for providers, billing professionals, and policy analysts seeking a concise, national-level briefing on CPT code 92605 and its role in assessing non–speech–generating communication devices.
Billing Code Overview
CPT code 92605 describes a face-to-face evaluation lasting one hour in which a qualified provider assesses a patient’s abilities to determine the most appropriate non–speech–generating communication device. The service includes interaction with the patient’s caregiver to gather relevant information and feedback that informs device selection and fitting.
Service Type: Augmentative and Alternative Communication (AAC) device evaluation, comprehensive (1 hour)
Typical Site of Service: Outpatient clinic or rehabilitation facility, including speech-language pathology clinics and multidisciplinary assistive-technology centers.
Clinical & Coding Specifications
Clinical Context
A 9-year-old nonverbal child with cerebral palsy and severe motor impairment is referred for an assistive communication evaluation to determine an appropriate non–speech–generating communication device. The multidisciplinary workflow begins with the speech-language pathologist (SLP) obtaining history from the family and school team, reviewing prior therapies and cognitive/vision/motor assessments, and performing a face-to-face, one-hour assessment of the child’s expressive intent, motor access (e.g., direct touch, switch, eye gaze), auditory and visual attention, and receptive language. The SLP trials candidate devices and access methods, documents caregiver training needs, and collaborates with occupational therapy for positioning and access solutions. The SLP discusses device recommendations with the caregiver, documents device selection rationale, and completes any required forms for funding or durable medical equipment prior authorization. Typical site of service is an outpatient clinic-based therapy setting, school-based health program, or home visit when a clinic visit is not feasible. This service is billed as a one-hour, face-to-face evaluation using 92605.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | When billing only the clinician’s professional work separate from a facility’s technical component (rare for ). |