92522 CPT code
92522 CPT code is a code used by SLPs who evaluate clients with speech sound production impairments.
The official description of the 92522 CPT Code is:
Evaluation of speech sound production (e.g., articulation, phonological process, apraxia, dysarthria).
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You might be thinking, “Yes I provide these types of evaluations. But, what exactly is a CPT code, and when do I need to use it?”
CPT stands for Current Procedural Terminology CPT codes contribute to a standardized system of coding that’s managed by the American Medical Association (AMA).
When SLPs and other medical professionals use CPT codes on their documentation, it helps ensure consistency among them. CPT codes consist of five specific digits, which refer to a certain diagnosis.
Attaching the appropriate CPT code to documentation such as evaluation reports and treatment notes is required by Medicare and Medicaid for billing purposes. Many private insurance companies also require the use of CPT codes on therapists’ documentation.
It’s important for SLPs to stay in-the-know about commonly used CPT codes in their field, such as 92522. That can help improve the efficiency and accuracy of their documentation and billing.
A current list of CPT codes is available to view on the Centers for Medicare & Medicaid Services (CMS) website.
Follow along for the important details on how, when, where, and why to use the CPT Code 92522.
What is the 92522 CPT code?
The 92522 CPT code description is: Evaluation of speech sound production (e.g., articulation, phonological process, apraxia, dysarthria).
It should be used by speech language pathologists when billing an evaluation that assesses a client’s speech production skills.
The evaluation should be focused on assessing a client’s production/articulation of speech sounds.
This might include one or more of the following components:
- Apraxia assessment (may include a standardized test such as the Kaufman Speech Praxis Test (KSPT))
- Articulation assessment (may include a standardized test such as the Goldman Fristoe Test of Articulation - 3rd Edition (GFTA-3)
- Assessment/Analysis of Phonological processes (possibly including a standardized assessment such as the Comprehensive Test of Phonological Processing 2nd Edition (CTOPP-2)
- An analysis of a client’s Dysarthria (may include an assessment such as the Frenchay Dysarthria Assessment (FDA-2))
- An Oral Peripheral Examination (assessment of oral musculature, including the strength and coordination and it relates to speech production abilities)
- Client history
Speech language pathologists can bill the 92522 CPT code. This code is procedure based. It can only be billed once per day for a specific client.
ASHA encourages SLPs to strive to identify and use the “best” code to describe the services they provide.
Here are some examples of procedures in which the provider can attach the 92522 CPT code within documentation and billing:
- An articulation assessment for a 6-year-old child with sound substitutions.
- Evaluation of phonological processes for an 8-year-old child with a lisp, with typically developing expressive and receptive language skills (no language testing done).
- An adult client with ALS or facial paralysis who has normal comprehension and expressive language skills (no testing done), with dysarthria and decreased speech intelligibility.
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How to use the 92522 CPT code
CPT codes are categorized as either being timed or service-based procedures.
The 92522 CPT code is service-based. It should be used for the specific procedure that matches its description, regardless of how long the evaluation takes.
Follow these steps to correctly bill for the 92522 CPT code
- Refer to the AMA CPT manual to ensure that the 92522 CPT code is the most appropriate code for you to use for the service you provided.
- Complete documentation for the evaluation (i.e., a Speech Therapy Evaluation that includes an assessment of the client’s speech sound production skills).
- Attach the 92522 CPT code to your documentation.
- SLPs have the option of completing a superbill. This may be submitted directly to the payor (ex: Medicaid, Medicare, or private insurance) or can be given to the client.
- Automated billing is another option. This easy and efficient way of billing with the 92522 CPT code is offered by TheraPlatform.
The SLP’s documentation for the evaluation should reflect that the client has a treatment diagnosis related to the description of the 92522 CPT code.
There are several ICD-10 codes that may be associated with the need for an assessment of speech sound production.
These may include:
- F80.0 Specific Speech Articulation Disorder or Phonological Disorder
- R47.1 Dysarthria
- R48.2 Apraxia of Speech
- Other treatment diagnoses associated with speech sound production difficulties that may contribute to the client’s need for an assessment.
The assessment procedures targeted within the session should also relate to the areas outlined in the description for CPT code 92522.
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Do’s and don’ts of 92522 CPT code
Here are some key points to remember, and errors to avoid when billing the 92522 CPT code.
This can help reduce the likeliness of a reimbursement denial:
- Use the code for evaluation, not treatment.
- Do not bill using the 92522 CPT code more than one time in a day.
- Do not use this code if the evaluation also included an assessment of the client’s expressive or receptive language skills. For this, use the CPT code 92523: Evaluation of speech sound production with evaluation of language comprehension and expression.
- Do not bill CPT code 92522 in conjunction with CPT code 92523.
Reimbursement for 92522 CPT code
Speech therapists can view which CPT codes to use for various services by referring to ASHA’s Medicare Fee Schedule for Speech-Language Pathologists. This source also lists current reimbursement rates for Speech Therapy Services.
The 2023 national fee for the 92522 CPT code is $109.43.
Reimbursement rates of private insurance payers vary according to specific plans. Determining whether the client’s insurance plan covers Speech Therapy (including an evaluation with the 92522 CPT code) for their specific diagnosis is important.
It’s recommended that you and your client verify this prior to initiating services. That can help maximize reimbursement for this code.
Some private providers choose to set their prices for services to be similar to Medicare or Medicaid reimbursement rates.
Coding changes
Clinicians should stay current on updates to CPT codes, which are performed periodically. Changes may affect the way the clinician bills for services.
SLPs can remain up to date with changes to the 92522 CPT code by checking the AMA’s CPT codebook when updates are made. CPT codes are updated by the AMA annually and are effective for use on January 1st of each year.
Speech language pathologists who work with clients with speech sound disorders such as articulation disorders, phonological Disorders, Apraxia of speech, and Dysarthria, should be familiar with the 92522 CPT code.
By staying current on what types of treatment the code includes and when to use it, providers can have more assurance that they’re following AMA guidelines and will receive reimbursement for services.
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How EHR and practice management software can save speech therapists time with insurance billing
EHR with integrated billing software and a clearing house, such as TheraPlatform, offers speech therapists significant advantages in creating an efficient insurance billing process. The key is minimizing the amount of time dedicated to developing, sending, and tracking medical claims through features such as automation and batching.
What are automation and batching?
- Automation refers to setting up software to perform tasks with limited human interaction.
- Batching or performing administrative tasks in blocks of time at once allows you to perform a task from a single entry point with less clicking.
Which billing and medical claim tasks can be automated and batched through billing software?
- Invoices: Create multiple invoices for multiple clients with a click or two of a button or set up auto-invoice creation, and the software will automatically create invoices for you at the preferred time. You can even have the system automatically send invoices to your clients.
- Credit card processing: Charge multiple clients with a click of a button or set up auto credit card billing, and the billing software will automatically charge the card (easier than swiping!)
- Email payment reminders: Never manually send another reminder email for payment again, or skip this altogether by enabling auto credit card charges.
- Automated claim creation and submission: Batch multiple claims with one button click or turn auto claim creation and submission on.
- Live claim validation: The system reviews each claim to catch any human errors before submission, saving you time and reducing rejected claims.
- Automated payment posting: Streamline posting procedures for paid medical claims with ERA. When insurance offers ERA, all their payments will post automatically on TheraPlatform's EHR.
- Tracking: Track payment and profits, including aging invoices, overdue invoices, transactions, billed services, service providers.
Utilizing billing software integrated with an EHR and practice management software can make storing and sharing billing and insurance easy and save providers time when it comes to insurance billing for therapists.
Resources
TheraPlatform is an all-in-one EHR, practice management, and teletherapy software built for therapists to help them save time on admin tasks. It offers a 30-day risk-free trial with no credit card required and supports different industries and sizes of practices, including speech-language pathologists in group and solo practices.
More resources
- Therapy resources and worksheets
- Therapy private practice courses
- Ultimate teletherapy ebook
- The Ultimate Insurance Billing Guide for Therapists
- The Ultimate Guide to Starting a Private Therapy Practice
- Insurance billing 101
- Practice management tools
