CPT 92522 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Medicine Services and Procedures • Special Otorhinolaryngologic Services and Procedures |
| Common Place of Service | • 11 - Office • None |
| Common Modifiers | • None • GN - Services delivered under an outpatient speech language pathology plan of care • 96 |
| Complexity Level | Low |
National average reimbursement for CPT 92522 by major payers:
$131.41
$121.62
$111.40
$178.66
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 92522 | ||||||
United | 92522 | $145.66 | 1770562258 - TERESA ERRIGO VITALE | 135562308 - NEW YORK UNIVERSITY | NY | Physical Therapist (225100000X) |
United | 92522 | $145.58 | 1235726423 - KINJAL PATEL | 222398304 - (NJ) SEAVIEW ORTHOPAEDICS & MEDICAL ASSOCIATES | NY | Physical Therapist (225100000X) |
United | 92522 | $69.75 | 1396106878 - ANTHONY RIZZITIELLO-BRESTOLLI | 273695360 | NY | Occupational Therapist (225X00000X) |
United | 92522 | $131.50 | 1316166317 - ROBBIE HOYT | 141338386 - (NY) SUNNYVIEW HOSPITAL AND REHABILITATION CENTER | NY | Physical Therapist (225100000X) |
United | 92522 | $77.73 | 1194845123 - LISA GRADZIEL | 141395426 - (NY) THE CENTER FOR DISCOVERY INC | NY | Physical Therapist (225100000X) |
United | 92522 | $76.20 | 1194920686 - MARIA SILVINA AGAO | 330999346 | NY | Physical Therapist (225100000X) |
United | 92522 | $113.66 | 1992804066 - KELLY BIENICK | 141425851 - (NY) CENTER FOR DISABILITY SERVICES INC | NY | Speech-Language Pathologist (235Z00000X) |
United | 92522 | $104.26 | 1851958490 - WIRTH PHYSICAL THERAPY PC | 833683652 - (NY) WIRTH PHYSICAL THERAPY PC | NY | Physical Therapist (225100000X) |
United | 92522 | $159.63 | 1093263576 - ETHAN DINAN | 160982095 - (NY) NORTH COUNTRY ORTHOPAEDIC GROUP P C | PA | Physical Therapist (225100000X) |
United | 92522 | $102.41 | 1942342613 - SANDRA SMITH | 131740114 - MONTEFIORE MEDICAL CENTER | NY | Physical Therapist (225100000X) |
United | 92522 | $76.20 | 1083921662 - SHIFRA WEISS | 112329960 - (NY) ODA PRIMARY HEALTH CARE NETWORK INC | NY | Speech-Language Pathologist (235Z00000X) |
United | 92522 | $90.20 | 1063964963 - AMY PIACENTINI | 113355604 - (NY) PROHEALTH CARE ASSOCIATES, LLP | NY | Physical Therapist (225100000X) |
United | 92522 | $104.26 | 1437585676 - NICOLE ROSE | 113465690 | NY | Occupational Therapist (225X00000X) |
United | 92522 | $90.33 | 1770040651 - ERICA GLASSMANN | 834136040 - (NY) SOUTH ISLAND ORTHOPEDICS PC | NY | Physical Therapist (225100000X) |
United | 92522 | $90.44 | 1902110570 - JOEL GOLDBERGER | 112329960 - (NY) ODA PRIMARY HEALTH CARE NETWORK INC | NY | Speech-Language Pathologist (235Z00000X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 92522 vs. Other Special Otorhinolaryngologic Services and Procedures Codes
The CPT 92522 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 92522 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 |
|---|---|---|
| 92521-CPT | Low | Evaluation Of Speech Continuity, Smoothness, Rate, And Effort |
| 92522-CPT | Low | Evaluation Of Speech Sound Production (Eg, Articulation,Phonological Process,Apraxia, Dysarthria); |
| 92523-CPT | Moderate | Evaluation Of Speech Production (Eg Articulation Phonological Process Apraxia Dysarthria); With Evaluation Of Language Comprehension And Expression (Eg Receptive And Expressive Language) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 92522. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 92522 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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