CPT 92607 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 • 59 - Distinct Procedural Service |
| Complexity Level | Low |
National average reimbursement for CPT 92607 by major payers:
$161.52
$170.38
$160.22
$209.18
| 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 92607 | ||||||
United | 92607 | $204.64 | 1821447285 - CHERIECE MCNEELY | 362235167 - ROSECRANCE INC | IL | Psychiatry Physician (2084P0800X) |
United | 92607 | $248.77 | 1518318716 - LADAN KHAZAI | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | IL | Psychiatry Physician (2084P0800X) |
United | 92607 | $276.44 | 1285715847 - SHANNON JENNINGS | 362604009 - (IL) OTTAWA REGIONAL HOSPITAL & HEALTHCARE CENTER | IL | Psychiatry Physician (2084P0800X) |
United | 92607 | $137.72 | 1700175783 - MY PHON NGUYEN | 363305449 - (IL) MOUNT SINAI COMMUNITY FOUNDATION | IL | Psychiatry Physician (2084P0800X) |
United | 92607 | $171.53 | 1225211600 - JOHN MILLICHAP | 262037695 - GRADY MEMORIAL HOSPITAL CORPORATION | NC | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 92607 | $244.50 | 1245252303 - MARY FAHRMEIER | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | WI | Psychiatry Physician (2084P0800X) |
United | 92607 | $221.32 | 1932130325 - ELIZABETH BERRY-KRAVIS | 911780160 | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 92607 | $215.74 | 1215968755 - STACEY OCCOMY | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IN | Psychiatry Physician (2084P0800X) |
United | 92607 | $223.63 | 1033328869 - LEAH USTAS | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Psychiatry Physician (2084P0800X) |
United | 92607 | $433.17 | 1144203753 - HAIDAR KABBANI | 363279680 - (IL) PEDIATRIC FACULTY FOUNDATION IN | OH | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 92607 | $244.50 | 1619130648 - APARNA SHARMA | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | IL | Psychiatry Physician (2084P0800X) |
United | 92607 | $249.58 | 1386755486 - DOUGLAS NORDLI | 205521741 - SOUTHERN ILLINOIS MEDICAL SERVICES NFP | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 92607 | $384.20 | 1992904197 - JOANNA BLACKBURN | 363279680 - (IL) PEDIATRIC FACULTY FOUNDATION IN | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 92607 | $433.17 | 1255696290 - COURTNEY ROMBA | 364187449 | IL | Psychiatry Physician (2084P0800X) |
United | 92607 | $160.75 | 1578555256 - VIKTORIA ERHARDT | 363317058 - (IL) ACCESS COMMUNITY HEALTH NETWORK | IL | Psychiatry Physician (2084P0800X) |
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 92607 vs. Other Special Otorhinolaryngologic Services and Procedures Codes
The CPT 92607 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 92607 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 |
|---|---|---|
| 92605-CPT | Low | Evaluation For Prescription Of Non-Speech-Generating Augmentative And Alternative Communication Device, Face-To-Face With The Patient; First Hour |
| 92606-CPT | Low | Therapeutic Service(S) For The Use Of Non-Speech-Generating Device, Including Programming And Modification |
| 92607-CPT | Low | Evaluation For Prescription For Speech-Generating Augmentative And Alternative Communication Device, Face-To-Face With The Patient; First Hour |
| 92608-CPT | Low | Evaluation For Prescription For Speech-Generating Augmentative And Alternative Communication Device, Face-To-Face With The Patient; Each Additional 30 Minutes (List Separately In Addition To Code For Primary Procedure) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 92607. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 92607 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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