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See a sample rate comparisonCPT 92521 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Speech Evaluation, An Evaluation Of The Smoothness Or Flow With Which Sounds Syllables Words And Phrases Are Joined Together When A Person Is Speaking And The Identification Of Any Stuttering Or Cluttering.
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Special Otorhinolaryngologic Services and Procedures |
| Common Place of Service | 11 - Office 10 - Telehealth in Patient's Home |
| Common Modifiers | GN - Services delivered under an outpatient speech language pathology plan of care 96 |
| Complexity Level | Low |
| Medicare Fee Schedule | $133.27 national non-facility rate (2026) · View Medicare rates for 92521 |
| Medicaid Fee Schedule | $107.95 median of the 7 states in the free preview · View Medicaid rates for 92521 |
National average reimbursement for CPT 92521 by major payers:
$154.29
$148.75
$125.19
$186.51
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CPT 92521
5 of 25 sample ratesHigher to lower in this preview
Jaimie Bartuccio
Virginia Mason Medical Center
$281.07Published rateLeah Cavanaugh
North Central Ohio Family Care Center Inc
$116.23Published rateCasa Speech, LLC
Casa Speech LLC
$111.51Published rateAbigail Berlin
Boundless Strategic Resources Inc
$94.77Published rateExpressable Speech-Language Pathology, P.C.
Expressable Speech-Language Pathology P.C.
$35.00Published rate
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See a sample payer proposalCPT 92521 vs. Other Special Otorhinolaryngologic Services and Procedures Codes
The CPT 92521 code is part of the Medicine Services and Procedures services used for Special Otorhinolaryngologic Services and Procedures. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 92521 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 92520-CPT | Low | Laryngeal Funct Studie (Ie Aerodynamic Tsting & Acoustic Testi, Laryngeal Function Studies (Ie Aerodynamic Testing And Acoustic Testi |
| 92521-CPT | Low | Speech Evaluation, An Evaluation Of The Smoothness Or Flow With Which Sounds Syllables Words And Phrases Are Joined Together When A Person Is Speaking And The Identification Of Any Stuttering Or Cluttering. |
| 92522-CPT | Low | Eval Of Speech Sound Producti (Eg Articulation Phonological, Evaluation Of Speech Sound Production (Eg Articulation Phonological |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 92521. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 92521 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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