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See a sample rate comparisonCPT 92630 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.
Speech And Hearing Therapy, Auditory Rehabilitation Therapy. Auditory Rehabilitation Is Training Or Therapy To Improve Hearing Skills And The Ability To Communicate.
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Special Otorhinolaryngologic Services and Procedures |
| Common Place of Service | 11 - Office |
| Common Modifiers | 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 92630 |
| Medicaid Fee Schedule | $78.25 median of the 7 states in the free preview · View Medicaid rates for 92630 |
National average reimbursement for CPT 92630 by major payers:
$185.25
$125.18
$98.34
$164.12
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CPT 92630
1 of 1 sample ratesHigher to lower in this preview
Ram Balasubramanian
$68.73Published rate
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See a sample payer proposalCPT 92630 vs. Other Special Otorhinolaryngologic Services and Procedures Codes
The CPT 92630 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 92630 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 |
|---|---|---|
| 92596-CPT | Low | Ear Protector Attenuatn Measuremnts |
| 92620-CPT | Low | Evaluate Hearing Function, Central Auditory Function Exam. Central Auditory Processes Are Responsible For What The Brain Does With What It Hears. |
| 92630-CPT | Low | Speech And Hearing Therapy, Auditory Rehabilitation Therapy. Auditory Rehabilitation Is Training Or Therapy To Improve Hearing Skills And The Ability To Communicate. |
| 92633-CPT | Low | Speech And Hearing Therapy, Auditory Rehabilitation Therapy. Auditory Rehabilitation Is Training Or Therapy To Improve Hearing Skills And The Ability To Communicate. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 92630. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 92630 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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