Can I bill 92507 for adults?

Yes—no age limits, but insurers may require prior authorization for adults.

How many units can I bill per day?

Typically 2–4 units (30–120 mins), but verify with payer.

Do 92507 cover bilingual therapy?

Yes, if addressing a disorder (e.g., language delay), not language difference.

3811 Ditmars Blvd# 1124, Astoria, NY 11105

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CPT Code 92507 the Ultimate Guide for Speech Therapy Billing

Name: Cures Medical Billing Services Company
Address: 3811 Ditmars Blvd# 1124, Astoria, NY 11105, Astoria, NY, 11105, USA
Telephone: +1 (917) 994-9941

CPT Code 92507 is the standard billing code for individual speech-language pathology sessions addressing speech, language, voice, communication, or auditory processing disorders. SLPS must apply this code correctly to avoid claim rejections and maximize reimbursement.

What is CPT Code 92507?

CPT 92507 (Current Procedural Terminology) is defined as:

Personalized therapy for speech, language, vocal, communication, and/or auditory processing challenges.

Covered Services Include

Articulation or fluency therapy
Voice disorder rehabilitation (e.g., post-laryngectomy)
Cognitive-communication therapy (e.g., post-stroke)
Auditory processing disorder treatment
AAC (augmentative and alternative communication) training

Exclusions

Group therapy (use 92508)
Evaluations (e.g., 92607 for speech-generating device assessments)
Swallowing therapy (use 92526)

Key Components of Billing CPT 92507

Time Requirements

1 Unit = 15–45 minutes of direct, one-on-one therapy.
Billing Multiple Units:
- Example: A 60-minute session = 2 units (15+45 minutes).
- Payer rules vary: Medicare caps daily units at 4 (1 hour), while private insurers may allow more.

Modifiers

Modifier	Purpose	Example
GN	Required for Medicare claims under a speech-language pathology plan of care.	92507-GN
95	Telehealth services (real-time video).	92507-95
59	Distinct procedural service (if multiple therapies in one day).	92507-59

Critical Tip: Always check payer-specific modifier rules—some require GN + 95 for telehealth.

Telehealth Billing

Use modifier 95 for virtual sessions.
Ensure documentation includes:
- Patient consent for telehealth.
- Platform used (e.g., HIPAA-compliant software).

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Reimbursement & Denial Prevention

1. Factors Affecting Payment

Payer Policies: Medicare reimburses ~$75 per unit; private insurers vary.
Diagnosis Codes: Link to relevant ICD-10 codes (e.g., F80.1 for expressive language disorder).
Medical Necessity: Notes must show measurable goals (e.g., “Patient produced /r/ sound with 80% accuracy”).

2. Top Denial Reasons

Missing GN modifier (Medicare).
Insufficient time documentation.
Incorrectly billing group therapy as 92507.

Documentation Best Practices

SOAP Notes: Include time spent, specific exercises, and progress.
Example:

45-minute session targeting expressive aphasia via picture-naming drills. The patient achieved 70% accuracy in 2-syllable words.

Case Study - Correct vs. Incorrect Billing

Scenario: 30-minute telehealth session for a child with stuttering.
- Correct: 92507-95-GN + ICD-10 F98.5.
- Incorrect: 92507 alone (missing modifiers).

Related Codes

92526: Swallowing therapy.
92610: Voice prosthetic evaluation.
G0515: Medicare-covered telehealth add-on.

Final Thought

Mastering CPT 92507 ensures accurate reimbursement and minimizes audits. Always:
1. Track time meticulously.
2. Apply modifiers (GN/95).
3. Link to precise ICD-10 codes.
Need Help? Consult a billing specialist or bookmark this guide for quick reference!

FAQs

1. Can I bill 92507 for adults?
Yes—no age limits, but insurers may require prior authorization for adults.
2. How many units can I bill per day?
Typically 2–4 units (30–120 mins), but verify with payer.
3. Do 92507 cover bilingual therapy?
Yes, if addressing a disorder (e.g., language delay), not language difference.

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We are a team of national medical billing service experts based in Astoria, NY, committed to providing ongoing value to our customers. We leverage technology and implement best practices to provide high-quality and cost-efficient medical billing solutions from domestic locations, enabling customers to achieve their business goals. Cures Medical Billing is the best option for any medical billing needs.

At Cures Billing Services, we prioritize collaboration and recognize the uniqueness of each healthcare provider or organization
Maximize your revenue by focusing on growing your practice and let us handle all the back-end billing processes.
We can customize reports to support your practice’s unique requirements

Medical billing around Astoria, NY, and beyond is our core competency and our specialists will efficiently manage all your billing needs. Our medical billing specialists have over 12 Plus years of experience with all security technologies to ensure data integrity for our customers. Using our medical billing service, anyone can make their medical billing task less resource-consuming.