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See a sample rate comparisonCPT 92609 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.
Speaking Device Exam Training, Assessment And Training For Speech Generating Communication Device To Assist Person With Hearing Loss.
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Special Otorhinolaryngologic Services and Procedures |
| Common Place of Service | 11 - Office 15 - Mobile Unit |
| Common Modifiers | GN - Services delivered under an outpatient speech language pathology plan of care 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | $102.54 national non-facility rate (2026) · View Medicare rates for 92609 |
| Medicaid Fee Schedule | $86.46 median of the 7 states in the free preview · View Medicaid rates for 92609 |
National average reimbursement for CPT 92609 by major payers:
$128.08
$128.49
$120.90
$162.22
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CPT 92609
5 of 25 sample ratesHigher to lower in this preview
Srishti Nangia
$322.75Published rateMusaddiq Tariq
Loyola University Medical Center
$209.05Published rateAdventist Health Partners, Inc, Salt Creek Therapy Center
$182.85Published rateTown Center Orthopaedic Associates, P.C.
$101.86Published rateMusaddiq Tariq
Bayhealth Medical Center Inc
$74.19Published rate
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See a sample payer proposalCPT 92609 vs. Other Special Otorhinolaryngologic Services and Procedures Codes
The CPT 92609 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 92609 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 |
|---|---|---|
| 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) |
| 92609-CPT | Low | Speaking Device Exam Training, Assessment And Training For Speech Generating Communication Device To Assist Person With Hearing Loss. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 92609. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 92609 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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Frequently Asked Questions
To get an accurate estimate for a specific medical procedure, especially one defined by a CPT code, for your particular location and provider, it's highly recommended to use a specialized fee schedule lookup tool. Payerprice offers a tool where you can search with the CPT code and your specific location to find detailed pricing information. This provides a more personalized and reliable cost estimate than general inquiries.
CPT (Current Procedural Terminology) codes are standardized five-digit alphanumeric codes used by healthcare professionals to describe medical, surgical, and diagnostic services. They are crucial for understanding healthcare costs because they are the universal language used for billing and claims processing by insurers and providers. Knowing the CPT code for a service allows you to research its typical cost and potential insurance coverage more effectively.
Medical procedure costs can vary significantly due to a multitude of factors, including the type of facility (hospital vs. outpatient clinic), geographic location, negotiated rates with different insurance companies, the complexity of the procedure, and the specific services included in the bundled price. For specific cost comparisons based on CPT codes and your location, tools like Payerprice can help provide insights into these variations.
For detailed fee schedules of common medical services based on CPT codes and specific geographic locations, you should use a dedicated pricing transparency tool. Payerprice provides a fee schedule lookup tool designed for users to search with CPT codes and their location to get accurate and relevant pricing data, helping you understand potential costs.
Generally, your insurance deductible applies to most medical services before your insurance company begins to pay its share. This means you are responsible for paying the full cost of covered services up to your deductible amount each policy year. However, preventative care services are often covered at 100% even before you meet your deductible. Always check your specific insurance policy details for what is covered pre-deductible.