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See a sample rate comparisonCPT 92597 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.
Evaluation For Use Andor Fitt, Evaluation For Use Andor Fitting Of Voice Prosthetic Oraugmentativealternative Communication Device To Supplement Oral Speech
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Special Otorhinolaryngologic Services and Procedures |
| Common Place of Service | 11 - Office 22 - On Campus Outpatient Hospital |
| Common Modifiers | GN - Services delivered under an outpatient speech language pathology plan of care KX - Requirements specified in the medical policy have been met |
| Complexity Level | Low |
| Medicare Fee Schedule | $71.14 national non-facility rate (2026) · View Medicare rates for 92597 |
| Medicaid Fee Schedule | $68.23 median of the 7 states in the free preview · View Medicaid rates for 92597 |
National average reimbursement for CPT 92597 by major payers:
$97.92
$103.56
$98.31
$116.88
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CPT 92597
5 of 25 sample ratesHigher to lower in this preview
Tamar Caceres
Pediatric Faculty Foundation In
$197.89Published rateMatthew Niedzwiecki
$145.86Published rateSulaiman Farooqui
Advocate Health And Hospitals Corporation
$130.00Published rateTrixie Lipke
Beaver Dam Community Hospitals Inc
$109.01Published rateDavid Kim
Town Center Orthopaedic Associates, P.C.
$67.59Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 92597 vs. Other Special Otorhinolaryngologic Services and Procedures Codes
The CPT 92597 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 92597 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 |
|---|---|---|
| 92597-CPT | Low | Evaluation For Use Andor Fitt, Evaluation For Use Andor Fitting Of Voice Prosthetic Oraugmentativealternative Communication Device To Supplement Oral Speech |
| 92605-CPT | Low | Evaluation For Prescription Of, Evaluation For Prescription Of Non-Speech-Generating Augmentative And Alternative Communication Device Face-To-Face With The Patient First Hour |
| 92606-CPT | Low | Communication Device Services, Assessment And Training For Non-Speech Generating Communication Device To Assist A Person With Hearing Loss. |
| 92607-CPT | Low | Ex For Speech Device Rx 1hr, Evaluation For Prescription For Speech Generating Augmentative And Alternative Communication Device Face To Face With The Patient First Hour |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 92597. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 92597 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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