CPT code 92523: Speech-language evaluation, speech plus language assessment2026 Medicare rate & RVUs

Medicare pays $226.46 for 92523 nationally in the office. Local office rates run $212.50–$296.80.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 92523 covers

A speech-language pathologist uses this evaluation when both speech sound production and language skills need assessment. For example, a child may have articulation concerns along with difficulty understanding or using language; an adult after a stroke may have speech production and language deficits. The clinician assesses relevant speech sounds and language comprehension and expression, then documents findings and recommendations in an outpatient rehabilitation clinic or hospital setting.

Report 92523 when the evaluation covers both speech sound production and receptive and expressive language. If the assessment addresses speech sound production alone, 92522 is the closer choice; do not separately report that service for the speech-production portion of the same combined evaluation. Documentation should identify the communication concerns assessed, the findings in both domains, and the resulting recommendations or plan. This is a therapy service, so modifier 26 does not apply. When multiple therapy services are furnished on the same day, CMS reduces practice expense for the second and later therapy units.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where 92523 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

92523 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the 92523 rate is calculated

Each of 92523’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

Payment rules and modifiers for 92523

The CMS indicators that decide how 92523 is paid alongside other services.

What modifiers do to the payment

92523 compared with similar codes

How to choose

92522Speech evaluationSpeech sound production

92522 addresses speech sound production alone. Choose 92523 when receptive and expressive language are also evaluated.

92521Speech evaluationFluency

92521 focuses on fluency concerns such as stuttering; 92523 combines speech sound production and language assessment.

92524Voice evaluationBehavioral and perceptual analysis

92524 evaluates voice characteristics and function. It is not the combined speech sound and language assessment represented by 92523.

Codes related to 92523

Related codes aren’t interchangeable: bill the code that matches the service performed.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Open CMS sourceHow we calculate rates