Summary & Overview
CPT 92620: Evaluation of Central Auditory Function, First Hour
CPT code 92620 represents a clinician-administered evaluation of central auditory function, documenting the first or only hour of testing to assess a patient’s ability to process auditory information and to help identify potential sites of abnormality within the central auditory pathways. This service is clinically important for diagnosing central auditory processing disorders and guiding management for patients with hearing-related speech and language or perceptual complaints.
This analysis covers major national payers including Aetna, Blue Cross Blue Shield, Cigna Health, United Healthcare, and Medicare. Readers will find a concise overview of coverage patterns among these payers, typical clinical settings for the procedure, and how CPT code 92620 relates to adjunctive tests and subsequent time-based reporting (for example, add-on time codes such as the additional 15-minute reporting structure represented by related codes).
The publication provides context on clinical indications, typical sites of service such as audiology clinics and otolaryngology outpatient settings, and relationships to commonly used auditory diagnostic tests. It also summarizes billing considerations and common scenarios when CPT code 92620 is used as the primary procedure. Data not available in the input prevents payer-specific reimbursement rates or utilization benchmarks from being included.
Billing Code Overview
CPT code 92620 describes an evaluation of central auditory function. The provider performs diagnostic testing to assess how the patient processes auditory information and to help localize potential abnormalities in the central auditory pathways. This code represents the first or only hour of testing performed by the clinician.
Service Type: Diagnostic auditory processing evaluation
Typical Site of Service: Audiology clinic or otolaryngology outpatient setting
Clinical & Coding Specifications
Clinical Context
A 10-year-old child is referred by a pediatrician and speech-language pathologist for evaluation of suspected central auditory processing disorder after persistent difficulty following verbal instructions in classroom settings and delayed language progress despite normal peripheral hearing screens. The audiologist obtains history including birth, developmental milestones, noise exposure, and academic concerns. Testing is scheduled in a sound-treated booth; the provider performs a battery targeting central auditory function lasting approximately one hour, corresponding to CPT 92620. Tests may include filtered speech, staggered spondaic word, and synthetic sentence identification procedures as indicated. Results are scored and interpreted during the visit; a separate written report may be billed with additional time or with CPT 92621 for each additional 15 minutes of testing. Results inform recommendations for classroom accommodations, auditory training referrals, or further neurologic evaluation when a site of lesion in the central auditory pathways is suspected.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | When billing only the interpreting clinician’s professional service separate from technical equipment use |