CPT code 92523: Speech-language evaluation, speech plus language assessment2026 Medicare rate & RVUs in California
A speech-language pathologist evaluates speech sound production together with receptive and expressive language to characterize combined communication concerns.
Medicare pays $237.88–$283.67 for 92523 in the office in California, from Chico, CA to San Benito County, CA. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
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 in California
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
29 payment localities
$237.88 to $283.67
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield, CA | $238.16 | Unavailable |
| Chico, CA | $237.88 | Unavailable |
| El Centro, CA | $237.88 | Unavailable |
| Fresno, CA | $237.88 | Unavailable |
| Hanford, CA | $237.88 | Unavailable |
| Los Angeles, CA | $249.51 | Unavailable |
| Madera, CA | $237.88 | Unavailable |
| Marin County, CA | $278.59 | Unavailable |
| Merced, CA | $237.88 | Unavailable |
| Modesto, CA | $237.88 | Unavailable |
| Napa, CA | $265.50 | Unavailable |
| Oxnard, CA | $247.73 | Unavailable |
| Redding, CA | $237.88 | Unavailable |
| Rest of California | $237.88 | Unavailable |
| Riverside, CA | $238.11 | Unavailable |
| Sacramento, CA | $246.87 | Unavailable |
| Salinas, CA | $245.84 | Unavailable |
| San Benito County, CA | $283.67 | Unavailable |
| San Diego, CA | $249.33 | Unavailable |
| San Francisco, CA | $278.58 | Unavailable |
| San Luis Obispo, CA | $242.09 | Unavailable |
| Santa Clara County, CA | $283.62 | Unavailable |
| Santa Cruz, CA | $250.04 | Unavailable |
| Santa Maria, CA | $246.14 | Unavailable |
| Santa Rosa, CA | $252.46 | Unavailable |
| Stockton, CA | $237.88 | Unavailable |
| Vallejo, CA | $265.48 | Unavailable |
| Visalia, CA | $237.88 | Unavailable |
| Yuba City, CA | $237.88 | Unavailable |
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.
How the rate is built · 92523
RVUs × geographic indexes × conversion factor
Work3.84
3.84 RVUs× 1.000 GPCI
Practice expense2.93
2.93 RVUs× 1.000 GPCI
Malpractice0.01
0.01 RVUs× 1.000 GPCI
Adjusted RVUs
6.7800
Conversion factor
$33.4009
Medicare rate
$226.46
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 92523
The CMS indicators that decide how 92523 is paid alongside other services.
CMS payment indicators · 92523
Speech-language evaluation, speech plus language assessment
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 5 | Therapy reduction: practice expense of the second and later units is reduced. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 7 | Therapy service: the split doesn’t apply. |
What modifiers do to the payment
Modifier CQ · payment effect
With and without the modifier
92523 without CQ · national office
$226.46
Speech-language evaluation, speech plus language assessment
92523-CQ · Allowed amount unchanged
$226.46
Medicare cuts its own payment by 15% after the patient’s 20% coinsurance; the allowed amount stays the same. On $100 allowed: $20 coinsurance, then Medicare pays $68 instead of $80.
92523 compared with similar codes
Compare codes · National
4 codes, side by side
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.
92523 billing questions
When should 92523 be chosen instead of 92522?
Use 92523 when the evaluation includes speech sound production and receptive and expressive language. Use 92522 when the assessment is limited to speech sound production.
Can 92522 also be reported for the speech portion of the same evaluation?
Do not separately report 92522 for the speech-production portion included in the combined 92523 evaluation.
Does modifier 26 apply?
No. CMS identifies 92523 as a therapy service for which the professional component modifier does not apply.
Does CMS reduce payment when other therapy services are billed the same day?
Yes. CMS reduces practice expense for the second and later therapy units furnished on the same day.
How does 92523 differ from a fluency evaluation?
92523 assesses speech sound production and language comprehension and expression. Use 92521 when the evaluation is focused on speech fluency.
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
Show the CMS file lines behind this rate
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