Coding Change in Speech Therapy Evaluations

This provider bulletin is an update about information in the Blue Cross and Blue Shield of Texas Provider Operations Manual .

In an effort to gain a more accurate and appropriate evaluation of the professional work performed, the American Medical Association (AMA) developed new Evaluation of Speech codes to include a “professional work” value that would better measure the amount of time, technical skill, physical effort, stress and judgment required to perform the service.

Effective January 1, 2014, CPT Code 92506 (Evaluation of Speech) was terminated and has been replaced with four new codes designed to more specifically evaluate language, fluency, voice and speech disorders.

The new codes are:

  • 92521 — Evaluation of speech fluency (e.g., stuttering, cluttering)
  • 92522 — Evaluation of speech sound production (e.g., articulation, phonological process, apraxia, dysarthria)
  • 92523 — Evaluation of speech sound production (e.g., articulation, phonological process, apraxia, dysarthria); with evaluation of language comprehension and expression (e.g., receptive and expressive language)
  • 92524 — Behavioral and qualitative analysis of voice and resonance

These new codes are in effect for dates of service on or after January 1, 2014. Please note that claims submitted using code 92506 with dates of service for January 1, 2014 and after will be denied. For services provided on or after January 1, 2014, we will continue to pay the rate associated with code 92506 for the new 2014 codes until we receive updated rate information from the state, at which time we will adjust the rate accordingly which may result in request for refunds.

For additional information about the coding change, visit the website of the American Speech-Hearing Association (ASHA) .

If you have questions, please contact the Customer Care Center at 888-292-4487.