Speech therapy billing services for speech-language pathologists

Why is SLP billing hard?

• The main treatment code changes in 2027

  Individual speech and language treatment is billed with 92507, once per session, through December 31, 2026. From January 1, 2027 it is replaced by ten timed codes by clinical area (92654–92663), and each payer decides when it adopts them.

• Untimed and timed codes side by side

  Swallowing treatment (92526) and the evaluations are billed once per session, while cognitive treatment (97129, 97130) is timed, so one practice counts units more than one way.

• Evaluations can’t all be combined

  Each evaluation code has a set scope: 92523 includes the speech sound evaluation in 92522, so the two aren’t billed together, while fluency (92521), voice (92524) and swallowing (92610) are separate codes.

• The plan of care has deadlines

  As in physical therapy, Medicare wants the plan of care signed by the physician or NPP within 30 days of the first treatment, recertified at least every 90 days, and a progress report at least every 10 treatment days.

• A threshold shared with PT

  SLP services carry the GN modifier, and speech therapy shares Medicare’s yearly therapy threshold with physical therapy, so a patient may need the KX modifier sooner if they also had PT that year.