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Regulatory Update: Speech Therapy Treatment Coding

Written by Functional Pathways | Nov 13, 2026, 6:26:47 PM

Medicare Changes

Medicare’s Calendar Year 2027 Physician Fee Schedule (PFS) includes changes to the treatment codes used for speech-language pathology services. The new codes will take effect January 1, 2027.

Greater Coding Specificity

The new coding structure will allow certain one-on-one speech-language pathology services to be reported in greater detail based on the type of treatment provided.

Current Code and Next Steps

Speech-language pathologists currently use CPT code 92507 for the treatment of speech, language, voice, communication, and auditory processing disorders. The American Medical Association (AMA) CPT Editorial Panel has approved new codes that more clearly identify these services.

Medicare Payment: CMS has finalized payment values for the new codes in the Calendar Year 2027 PFS final rule.

Final Payment Values: Medicare’s final payment values were published in the CY 2027 PFS final rule.

Other Payers: Each payer will determine whether and when to add the new codes to its fee schedule.

The American Speech-Language-Hearing Association (ASHA) has provided guidance for use of these codes.

Clinical Service

Code

Long Descriptor

Fluency disorders

92654

Treatment of fluency disorder (e.g., stuttering and cluttering), direct (1:1) patient contact; initial 30 minutes. Time to report: 16-37 minutes to report 1 unit.

+92655

Each additional 15 minutes. 8–22 minutes to report 1 unit after reporting the base code.

(Use 92655 in conjunction with 92654)

(Do not report 92654, 92655 in conjunction with 97153, 97155)

Speech sound production disorders

92656

Treatment of speech sound production disorder (e.g., articulation, phonological process, apraxia, dysarthria), direct

(one-on-one) patient contact; initial 30 minutes. 16–37 minutes to report 1 unit

(For treatment of speech sound production and language comprehension and expression disorder, see 92660, 92661)

+92657

Each additional 15 minutes. 8–22 minutes to report 1 unit after reporting the base code.

(Use 92657 in conjunction with 92656)

(Do not report 92656, 92657 in conjunction with 92658, 92659, 92660, 92661, 97153, 97155)

(For treatment of speech sound production and language comprehension and expression disorder, see 92660, 92661)

Language comprehension

and expression disorders

92658

Treatment of language comprehension and expression disorder (e.g., receptive and expressive language), direct (one-onone) patient contact; initial 30 minutes. 16–37 minutes to report 1 unit.

(For treatment of speech sound production and language comprehension and expression disorder, see 92660, 92661)

+92659

Each additional 15 minutes. 8–22 minutes to report 1 unit after reporting the base code.

(Use 92659 in conjunction with 92658)

(Do not report 92658, 92659 in conjunction with 92656, 92657, 92660, 92661, 97153, 97155)

(For treatment of speech sound production and language comprehension and expression disorder, see 92660, 92661)

Combined speech sound production and language

92660

Treatment of speech sound production disorder (e.g., articulation, phonological process, apraxia, dysarthria) and language comprehension and expression disorder (e.g., receptive and expressive language), direct (one-on-one) patient contact; initial 30 minutes. 16–37 minutes to report 1 unit.

+92661

Each additional 15 minutes. 8–22 minutes to report 1 unit after reporting the base code.

(Use 92661 in conjunction with 92660)

(Do not report 92660, 92661 in conjunction with 92656, 92657, 92658, 92659, 97153, 97155)

(To report treatment of speech sound production disorder only, see 92656, 92657)

(For treatment of language comprehension and expression disorder only, see 92658, 92659)

Voice, upper airway

dysfunction,

and/or resonance disorders

92662

Treatment of voice, upper airway dysfunction, and/or resonance disorders, direct (one-on-one) patient contact; initial 30 minutes. 16–37 minutes to report 1 unit.

+92663

Each additional 15 minutes. 8–22 minutes to report 1 unit after reporting the base code.

(Use 92663 in conjunction with 92662)

(Do not report 92662, 92663 in conjunction with 97153, 97155

Group

92508

Treatment of speech, language, voice, communication, and/or auditory processing disorder, group, 2 or more individuals. Untimed.

(Do not report 92508 in conjunction with 97154, 97158)

What the Codes Address

  • Fluency disorders
  • Speech sound production disorders
  • Language comprehension and expression disorders
  • Combined speech sound production and language treatment
  • Voice, upper airway dysfunction, and resonance disorders

Why Treatment Time Matters

These individual treatment codes use a base-and-add-on structure. Add-on codes must be reported with the matching base code, and the same treatment time cannot support more than one service. Because payer requirements may differ, applicable payer policies should always be reviewed.

Documentation Remains the Foundation

The medical record should identify the condition being addressed, functional communication goals, skilled intervention, the resident’s response or progress, and the direct treatment time. When multiple services are reported, the documentation should clearly distinguish the time and clinical purpose of each service.

Our Commitment: Functional Pathways is committed to accurate coding supported by clinically appropriate care and documentation that clearly reflects the services provided.

How We Are Preparing: Over the next two months, we will begin communicating with operational leaders and speech-language pathologists and providing training on the upcoming changes. This preparation will help ensure our teams are ready when the new codes take effect on January 1, 2027.

How Your Community Can Prepare

  • Make sure your billing software is updated with new codes.
  • Identify any payers that will not recognize the new CPT codes.

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