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 | Evaluative and Therapeutic Otorhinolaryngologic Services 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 |
| Medicare Fee Schedule | View Medicare rates for 92607 |
National average reimbursement for CPT 92607 by major payers:
$161.52
$170.38
$160.22
$207.89
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 92607 | $276.44 | 1285715847 - SHANNON JENNINGS | 362604009 - (IL) OTTAWA REGIONAL HOSPITAL & HEALTHCARE CENTER | IL | Psychiatry Physician (2084P0800X) |
United | 92607 | $131.96 | 1891771176 - CHRISTOPHER DREW | 541383504 - TOWN CENTER ORTHOPAEDIC ASSOCIATES, P.C. | VA | Physical Therapist (225100000X) |
United | 92607 | $289.05 | 1760412621 - RHONDA LAMPEN | 911352172 - MULTICARE HEALTH SYSTEM | MI | Psychiatry Physician (2084P0800X) |
United | 92607 | $147.94 | 1982629051 - THOMAS HERRMANN | 363637465 - (IL) HOOPESTON COMMUNITY MEMORIAL HOSPITAL | IL | Psychiatry Physician (2084P0800X) |
United | 92607 | $263.08 | 1225211600 - JOHN MILLICHAP | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | NC | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 92607 | $254.74 | 1376063370 - ABBY FREDRICKSON | 910844563 | IL | Psychiatry Physician (2084P0800X) |
United | 92607 | $248.77 | 1518318716 - LADAN KHAZAI | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | IL | Psychiatry Physician (2084P0800X) |
United | 92607 | $244.50 | 1366890857 - STEVEN SHARP | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | IL | Psychiatry Physician (2084P0800X) |
United | 92607 | $138.69 | 1801835202 - CHICAGO NEUROLOGY GROUP SC | 113666848 - (IL) CHICAGO NEUROLOGY GROUP, S.C. | IL | Psychiatry Physician (2084P0800X) |
United | 92607 | $238.25 | 1730246067 - SENADA BAJMAKOVIC-KACILA | 911780160 | IL | Psychiatry Physician (2084P0800X) |
United | 92607 | $254.74 | 1710206545 - NEIL JARIWALA | 910844563 | IN | Psychiatry Physician (2084P0800X) |
United | 92607 | $194.27 | 1104020866 - JAMIE PACIS | 363149833 - NORTHWESTERN MEMORIAL HEALTHCARE | IL | Psychiatry Physician (2084P0800X) |
United | 92607 | $244.50 | 1174859284 - MATTHEW NIEDZWIECKI | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | CA | Psychiatry Physician (2084P0800X) |
United | 92607 | $263.08 | 1811068554 - JAMES MACKENZIE | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 92607 | $131.96 | 1073530523 - DAVID KIM | 541383504 - TOWN CENTER ORTHOPAEDIC ASSOCIATES, P.C. | VA | Interventional Pain Medicine Physician (208VP0014X) |
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 Evaluative and Therapeutic Otorhinolaryngologic Services 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, 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 |
| 92608-CPT | Low | Ex For Speech Device Rx Addl, 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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