Billing and Coding: Speech-Language Pathology

Medicare covers speech-language pathology services (including treatment for speech/language disorders, dysphagia, and aural rehabilitation) when provided by a qualified SLP and when services are medically necessary, specific, and require the skills of a trained therapist. Coverage requires appropriate documentation of medical necessity, accurate ICD-10 diagnosis coding (Z01.818 for pre-laryngectomy when applicable), adherence to billing rules (modifier -GN, NCCI/OPPS edits), and use of evaluation CPT codes for re-evaluations; auditory processing codes 92507/92508 are billed as one unit per encounter.

"Speech-language pathology services are covered for diagnosis and treatment of speech and language disorders that result in communication disabilities."

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