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Changes Are Coming to 92507

Published in the March 2026 issue of the ISHA Voice.

By Lacey Peters and Danila McAsey, members of the Billing and Reimbursement Committee

There has been a lot of talk about the CPT© code 92507 under review by the AMA, and even more uncertainty.  ISHA’s Billing and Reimbursement Committee has been working diligently to learn the revision process, understand the concerns of Audiologists and Speech-Language Pathologists, and provide information to AuDs and SLPs in the State of Illinois about what can be expected next.  The following outlines information about what we know, what we do not know, what time-sensitive updates we have, and what steps you can take for advocacy to have your voice heard.

What we know:

  • AMA periodically reviews CPT© codes and valuations in concert with the CPT process and the Centers for Medicare & Medicaid Services (CMS) payment system to ensure codes reflect current and evolving clinical practice patterns and service delivery. 
  • 92507 was flagged to be reviewed due to a significant increase in billing Medicare for this code between the years of 2017 and 2022. 
  • A proposal was written and accepted by the AMA to delete 92507 and add 10 new codes in its place of 92507.  
    • The 10 codes are broken down by treatment type in their definitions.
    • 5 codes are considered base codes and billed for the first 30-minutes of the session
    • The other 5 codes are considered add-on codes and can be billed for each additional 15 minutes, and are intended to be used in conjunction with their corresponding base code (e.g., 45-minute fluency treatment session = 30-minute code for fluency + 15-minute add-on code for fluency)
  • The approved definitions for the 5 base codes that have been accepted are:
    • Treatment of fluency disorder (eg, stuttering and cluttering), direct (one-on-one) patient contact; initial 30 minutes 
    • Treatment of speech sound production disorder (eg, articulation, phonological process, apraxia, dysarthria), direct (one-on-one) patient contact; initial 30 minutes 
    • Treatment of language comprehension and expression disorder (eg, receptive and expressive language), direct (one-on-one) patient contact; initial 30 minutes
    • Treatment of speech sound production disorder (eg, articulation, phonological process, apraxia, dysarthria) and language comprehension and expression disorder (eg, receptive and expressive language), direct (one-on-one) patient contact; initial 30 minutes
    • Treatment of voice, upper airway dysfunction, and/or resonance disorders, direct (one-on-one) patient contact; initial 30 minutes 
  • Some limitations to billing have been identified by the AMA (e.g. you cannot bill CPT for Tx of speech sound production in conjunction with treatment of speech sound production & language comprehension)
  • The above changes are currently scheduled to go into effect on January 1, 2027

What we do not know:

  • We do not know the dollar amount for what Medicare, Medicaid, or private insurance will reimburse for any of these codes at this point.
  • While some of these codes cannot be billed together per their definitions, we do not yet know full billing recommendations and guidance for using these codes at this point.

 

Time-sensitive updates:

  • Another code change application has been submitted regarding this topic.
  • That application will be discussed and voted on at the CPT Editorial Panel Meeting on April 30-May 2, 2026.
  • Due to confidentiality constraints, specifics of the application document cannot be shared by the authors of this article.
  • If you would like to read the new proposal and submit comments to the CPT Editorial Panel regarding this proposal, the open comment period is March 6 - March 31st, 2026.

What steps can you take to learn more and advocate:

  • If you would like to review those documents and make comments about the new application, you can do so by following these steps:
    • Go to the AMA website: https://www.ama-assn.org/
      • Create a free account
    • Go to the interested party portal website and log in with the user name and password you just created on the AMA website: https://cptsmartapp.ama-assn.org/ 
    • Under the Interested Party Portal tab, request access to the application related to 92507
  • Read the new proposal documents to educate yourself on the proposed changes

Additional information regarding individual advocacy efforts:

  • If you choose to comment on the current proposal, it is important to follow the guidelines below.  
    • Comments should be related to the current application (you must follow the steps above and read the application to comment appropriately).
    • Comments should focus on the impact of patient care and best practices in Speech-Language Pathology.
    • Comments should directly state how the current application proposal will impact, positively or negatively, patient care and best practices in Speech-Language Pathology treatment. 
    • Comments should not address reimbursement or valuation at all.
    • Refer back frequently to ASHA’s Advocacy Page for updated information.  https://www.asha.org/advocacy/
    • Watch for updates from ISHA’s Billing and Reimbursement Committee through the ISHA Voice, ISHA website  https://www.ishail.org/ and timely email blasts.

References: 

AMA/Specialty Society RVS Update Process RUC Recommendations for CPT 2027.  January 2026 Meeting  https://www.ama-assn.org/

ASHA  https://www.asha.org/advocacy/

  • If you would like to review those documents and make comments about the new application, you can do so by following these steps:
    • o Go to the AMA website: https://www.ama-assn.org/
      • § Create a free account
      • o Go to the interested party portal website and log in with the user name and password you just created on the AMA website: https://cptsmartapp.ama-assn.org/ 
      • o Under the Interested Party Portal tab, request access to the application related to 92507.
      • Read the new proposal documents to educate yourself on the proposed changes.