The newest change to our school based Medicaid program went into effect on January 1, 2014.

In order for districts to maintain compliance for your Medicaid program please have your Speech providers conducting speech evaluations review these latest changes 

CPT Code 92506 – Evaluation of speech, language, voice, communication, and/or auditory processing has been deleted and is now replaced with four new, more specific evaluation codes related to language, speech sound production, voice and resonance, and fluency disorders.

The new speech evaluation codes are:

• 92521 – Evaluation of speech fluency (e.g. stuttering and, 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

Specific evaluation codes have been developed to replace CPT Code 92506 to more accurately and appropriately value the professional work performed by our clinicians. The new codes should be used for dates of service provided on or after January 1, 2014.

Any service dates through December 31, 2013 should be documented using code 92506. If services are not entered until after January 1, 2014 providers are instructed to use this code which will document the actual testing through December 31, 2013.

There will be times when a SLP provider may bill some of the new codes together because there are circumstances when it is appropriate for a child to be evaluated for multiple disorders on the same day. This documentation must clearly reflect a complete and distinct evaluation for each disorder.

A speech sound production evaluation (92522) is already included as a part of (92523) speech sound production evaluation with language evaluation and therefore may not be billed together on the same day.

For our Connecticut clients and many of our other States (please check with your Medicaid staff) evaluations involving more than one day should be submitted for the date of completion of the evaluation. Multiple bills should not be submitted for the same Evaluation for the same child that is conducted over a multiple day period.