Billing Cheat Sheet for Speech Therapy for 2025

At first glance, navigating speech therapy billing can seem as complex as the vocal cords and speech patterns therapists work with. Then add to that the busy daily routines of assessments, treatment sessions, and patient consultations, and you may quickly find that billing moves down the priority list.

Still, accurate billing is a non-negotiable if you want your practice to run smoothly.

Accurate and efficient billing keeps the administrative side of your speech therapy practice humming along and ensures compliance with national regulations and guidelines. With billing errors and healthcare discrepancies becoming a significant issue, understanding billing codes has never been more crucial.

According to MedCare MSO, approximately 80% of medical bills have errors, with the majority arising from coding mistakes. Furthermore, over 50% of insurance rejections result from incorrect billing inputs.

Ensuring your billing is up to scratch to sustain your practice and remain compliant. This can feel overwhelming…

… that’s where Zanda comes in.

Check out our speech therapy CPT codes cheat sheet – we’ve worked hard to make codes and billing for speech therapy as straightforward as possible by including commonly used and recently updated CPT and ICD-10 codes.

Important note from our legal eagles: This information is for reference only. It is your responsibility to ensure that claims are coded properly. Your professional association is a good place to start.

How Are CPT Codes & ICD-10 Codes Different?

CPT (Current Procedural Terminology) codes and ICD-10 (International Classification of Diseases, 10th Revision) codes are both essential in healthcare billing, and they serve distinct roles.

These codes are used hand-in-hand.

CPT Codes

CPT codes were developed by the American Medical Association (AMA). They define the specific intervention or treatment provided. – i.e. the service rendered.

CPT codes are displayed as a numerical sequence.

Here are a few examples:

92524 Behavioral and qualitative analysis of voice and resonance
92526 Treatment of swallowing dysfunction and/or oral function for feeding
92609 Therapeutic service(s) for the use of speech-generating devices, including programming and modification

ICD-10 Codes

ICD-10 codes give voice to the reason behind the therapy. They name the specific conditions or disorders a client presents with, from stuttering to voice disorders.

ICD-10 codes are represented by a letter followed by numbers.

Here are some examples:

D14.1 Benign neoplasm of larynx
D38.0 Neoplasm of uncertain behavior of larynx
G46.0 Middle cerebral artery syndrome

Common CPT Codes for Speech Therapy Evaluation and Treatment

Here’s a list of some of the most commonly used CPT codes for speech therapists.

31579 Diagnostic laryngoscopy with stroboscopy
92507 Treatment of speech, language, voice, communication, and/or auditory processing disorder; individual
92508 Treatment of speech, language, voice, communication, and/or auditory processing disorder; group, two or more individuals
92511 Nasopharyngoscopy with endoscope (separate procedure)
92520 Laryngeal function studies
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
92526 Treatment of swallowing dysfunction and/or oral function for feeding
92597 Evaluation for use and/or fitting of voice prosthetic device to supplement oral speech
92605 Evaluation for a prescription for non-speech generating AAC device, face-to-face with the patient; first hour
92618 Evaluation for a prescription for non-speech generating AAC device, face-to-face with the patient; each additional 30 minutes (add-on code for 92605)
92606 Therapeutic services for use of non-speech generating devices, including programming and modification
92607 Evaluation for prescription of speech-generating AAC device; first hour.
92608 Evaluation for prescription of speech-generating AAC device; each additional 30 minutes. Note that billing must occur in conjunction with 92607 on the claim form using the last date of service (do not bill separately from 92607).
92609 Therapeutic services for use of speech-generating device, including programming and modification
92610 Evaluation of oral and pharyngeal swallowing function
92611 Motion fluoroscopic evaluation of swallowing function by cine or video recording
92612 Flexible fiberoptic endoscopic evaluation of swallowing (FEES) by cine or video recording
97129 Therapeutic interventions that focus on cognitive function (e.g., attention, memory, reasoning, executive function, problem-solving, and/or pragmatic functioning) and compensatory strategies to manage the performance of an activity (e.g., managing time or schedules, initiating, organizing, and sequencing tasks), direct (one-on-one) patient contact; initial 15 minutes
97130 Therapeutic interventions that focus on cognitive function (eg, attention, memory, reasoning, executive function, problem-solving, and/or pragmatic functioning) and compensatory strategies to manage the performance of an activity (eg, managing time or schedules, initiating, organizing and sequencing tasks), direct (one-on-one) patient contact; each additional 15 minutes (list separately in addition to code for primary procedure)
97533 Sensory integrative techniques to enhance sensory processing and promote adaptive responses to environmental demands, direct (one-on-one) patient contact with the provider; each 15 minutes

CPT Code Modifiers Used in Speech Therapy Billing

Modifiers are added to CPT codes when a service or procedure has been altered due to an exceptional or mitigating circumstance.

Here are some common modifiers used:

-GN Used when Medicare Part B services are provided under a plan of care for speech-language pathology or dysphagia services.
-KX Used when the speech therapy professional attests that services at and above the therapy payment caps are medically necessary and reasonable. Justification is documented in the patient’s medical record.
-22 Used when the therapist believes the work required to provide a service is significantly greater than ordinarily required. Documentation must support this.
-52 Used for an abbreviated procedure.
-59 Used to identify procedures or services distinct from other procedures performed during the same day. They should only be used based on instruction from the payer. Medicare publishes National Correct Coding Initiative (CC) edits that may require this modifier.

Common ICD-10 Codes Used in Speech Therapy

The full list of ICD-10 codes used to describe speech and language pathology is extensive, but certain ICD-10 codes are applied more commonly than others in speech therapy practices.

Here are some of the most common ICD-10 codes used by speech therapists:

F80.0 Phonological Disorder
Patients with this disorder have difficulty making the correct sounds for a letter or a word.
F80.1 Expressive Language Disorder
May involve impairments with language form, content, or use of Augmentative and Alternative Communication (AAC) for certain clients.
F80.2 Mixed Receptive-Expressive Language Disorder
Displayed when a patient has difficulty in expressing their feelings and thoughts and understanding what others are saying. Also used when a child’s understanding of language is below the appropriate level for their mental age, and includes elective mutism. Usually, expressive language will also be markedly affected and abnormalities in word-sound production are common.
F80.81 Childhood-Onset Fluency Disorder
Characterized by the patient cluttering and stuttering.

R13.11 Dysphagia, Oral Phase
Difficulty swallowing food or liquids. Swallowing may be associated with pain or may not be possible.
R13.12 Dysphagia, Oropharyngeal Phase
Patient has trouble swallowing and the issue involves the patient’s lips, mouth, tongue, and pharynx.
R48.8 Other Symbolic Dysfunctions
Used to capture language deficits as the first-listed diagnosis.
R47.1 Dysarthria and Anarthria
A speech deficit caused by issues with controlling the muscles involved with speech production. Anarthria is the most severe form, which results in the inability to produce articulate and clear speech. Vowel sounds, in particular, may be distorted.
R48.2 Apraxia
A neurological condition – specifically, a motor planning disorder – where the patient finds it difficult or impossible to move their mouth and tongue to speak. Not to be confused with aphasia, where the person’s inability to speak is due to a problem with understanding or using the words.
R63.3 Feeding Difficulties
May be used for difficulty clearing the mouth of residue, difficulty establishing feeding, dependency for feeding, chewing finding, and difficulty chewing.
R63.31 Acute Pediatric Feeding Disorder
Refers to a disorder that has been present for less than 3 months. Speech therapists working with children with a Pediatric Feeding Disorder may modify food or liquid textures.
R63.32 Chronic Pediatric Feeding Disorder
Refers to a disorder that has been present for more than 3 months.
F80.4 Speech and Language Development Delay Due to Hearing Loss
Used for a developmental delay caused by hearing loss in children.

ICD-10 Codes & Zanda

How to Use Diagnosis Codes in Zanda

Every Zanda account is equipped with a default list of ICD-10 codes, but it’s also possible to add your own diagnosis codes to the system.

To add an ICD-10 code to a client’s profile, go to the menu on the left and navigate as follows:

• Go to People > Clients or click in the Quick Search on the top calendar panel.
• Type the client’s name in the search bar. Once the name appears in the drop-down list, click on it to open their profile.
• In the second menu on the top-left corner inside the client’s profile, go to Records > Diagnoses.
• Click the + Add Diagnoses button.
• In the ‘Diagnosis Code’ field, type in your desired diagnosis code. Once you start typing, autocomplete suggestions will appear in a dropdown list. From here, you can click on the code you want to enter.
• Enable the ‘Is Default’ switch to add the diagnosis to each new client invoice automatically.

Using Diagnosis Codes with Superbills in Zanda

If you want to display a client’s diagnosis in their Superbill, ensure you’ve selected the relevant diagnosis codes in all invoices for the client.

Here’s how:

• If you set a client’s diagnosis as ‘Default’ it will be added to each new invoice automatically. (See the instructions for adding new diagnosis codes to a client profile above)
• You can add diagnosis codes to existing client invoices retrospectively:
  • Go to People > Clients or click in the Quick Search on the top calendar panel.
  • Type the client’s name in the search bar. Once the name appears in the drop-down list, click on it to open their profile.
  • In the second menu on the top-left corner inside the client’s profile, go to Billing > Invoices.
  • Click on the invoice number to open it.
  • In the ‘Invoice Items’ section, you’ll see a box labeled ‘Diagnosis’ next to each item/service. Enter your desired diagnosis code here.
  • Once done, save the invoice. Repeat this process for all invoices you want to add to the client’s Superbill.

Now, you can generate a Superbill with the client’s diagnosis codes included.

Here’s how:

• Go to People > Clients or click in the Quick Search on the top calendar panel.
• Type the client’s name in the search bar. Once the name appears in the drop-down list, click on it to open their profile.
• In the second menu on the top-left corner inside the client’s profile, go to Billing > Statements/Superbill.
• Click + Create Statement. Choose ‘Type’ as Superbill.
• Create the statement by populating fields as desired. Then click Create Statement to generate the Superbill.

Common Questions About Speech Therapy Billing Codes

What is Code 92523 for Speech Therapy?

Code 92523 covers “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).”

The code should be used when using both formal and informal measures to evaluate speech and language skills. The evaluation may include language samples, speech samples, and standardized assessments.

What is CPT Code 92521 for Speech Therapy?

CPT code 92521: Evaluation of Speech Fluency. One of the most important CPT codes for speech therapists, CPT 92521 refers to the evaluation of speech fluency, specifically speech fluency disorders such as stuttering, cluttering, etc.

What is CPT Code 92526?

The CPT code 92526 description is: Treatment of swallowing dysfunction and/or oral function for feeding. Speech therapists should use this CPT code when billing an individual treatment session for feeding therapy.

This is a service-based code (not time-based) and can only be billed once a day for treatments, not evaluation. It can be used on the same day as a Dysphagia evaluation, but it must be a separate service. In addition, there should be an existing Plan of Care and the treatment session billed under CPT code 92526 should address the goals stated in the Plan of Care.
The session should address the goals as outlined by the American Speech-Language-Hearing Association.

A speech therapist could use the code 92526 for treatment sessions that include:

• Improving oral function with an adult patient
• Addressing a pediatric patient’s oral Dysphagia
• Modifying a patient’s liquids to help with swallowing difficulties
• Making changes to the nipple of a bottle for a baby showing signs of Dysphagia

What is CPT Code 97130 for Speech Therapy?

This code is used for each additional 15 minutes. It should be listed separately in addition to the code you use for the primary procedure.

It should always be billed in conjunction with 97129 (which covers therapeutic interventions that focus on cognitive function and compensatory strategies.)

Can You Bill 92507 and 92526 Together?

Yes, but only one unit of each can be billed per treatment day. An exception to this is when the treatment plan is delivered twice a day based on a BID treatment order. In this event, you will bill for two units of 92507 and 92526.

What CPT Code Should I Use for Speech Therapy Evaluation and Treatment?

CPT code 92521 is used for the evaluation of speech fluency. As such, it is one of the most important medical codes for speech therapists.

What is Speech Therapy CPT 92508 Used For?

According to the American Speech-Language-Hearing Association, code 92508 is for the treatment of speech, language, voice, communication, and/or auditory processing disorder. It’s used for groups of two or more individuals.

What Is the ICD-10 Code for Speech Therapy?

The most commonly used speech therapy ICD-10 codes are:

• F80.0
• F80.1
• F80.2
• F80.81
• R13.11
• R13.12
• R48.8
• R47.1
• R48.2
• R63.3
• R63.31
• R63.32
• F80.4

Are ICD-10 Codes Updated?

Yes, ICD-10 codes are reviewed and updated every October.

You can find accurate updates on the latest speech therapy ICD-10 codes on the CMS website.

Are There New Codes For Speech Therapy in 2025?

These are the new CPT codes effective from January 1, 2025 (from the American Speech-Language-Hearing Association (ASHA) website).

A note: While they may seem similar at first glance, these new G-codes for 2025 differ from the CPT codes introduced in 2024 (specifically numbers 97550-97552).

• G0541 – Caregiver training in direct care strategies and techniques to support care for patients with ongoing conditions or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present), face-to-face; initial 30 minutes
• G0542 – Caregiver training in direct care strategies and techniques to support care for patients with ongoing conditions or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present), face-to-face; each additional 15 minutes (List separately in addition to code for primary service). Use G0542 in conjunction with G0541.
• G0543 – Group caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present), face-to-face with multiple sets of caregivers

For reference, here are the codes that were introduced in 2024 – which are distinct from the G-codes above:

• 97550 – Caregiver training in strategies and techniques to facilitate the patient’s functional performance in the home or community (eg, activities of daily living [ADLs], instrumental ADLs [IADLs], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the patient present), face to face; initial 30 minutes
• 97551 – Caregiver training in strategies and techniques to facilitate the patient’s functional performance in the home or community (eg, activities of daily living [ADLs], instrumental ADLs [IADLs], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the patient present), face to face; each additional 15 minutes (list separately in addition to code for primary service) (Use 97551 in conjunction with 97550)
• 97552 – Group caregiver training in strategies and techniques to facilitate the patient’s functional performance in the home or community (eg, activities of daily living [ADLs], instrumental ADLs [iADLs], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the patient present), face to face with multiple sets of caregivers

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