CPT code 92523: Speech-language evaluation, speech plus language assessment2026 Medicare rate & RVUs in Colorado
A speech-language pathologist evaluates speech sound production together with receptive and expressive language to characterize combined communication concerns.
In Colorado, Medicare pays $234.19 for 92523 in the office.
Check a contract rate as a % of Medicare · 92523 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 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.
How Colorado compares for 92523
Across 109 of 109 payment localities, the office rate for 92523 runs from $212.50 in Arkansas to $296.80 in Alaska. Colorado pays $234.19. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Colorado · this page$234.19
- Los Angeles, CA · California$249.51+$15.32
- Washington, DC area · District of Columbia$250.84+$16.65
- Miami, FL · Florida$230.98−$3.21
- Chicago, IL · Illinois$228.28−$5.91
- Manhattan, NY · New York$250.72+$16.53
- Alaska · Alaska$296.80+$62.61
Other areas in Colorado first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $214.08 | — |
| ArkansasArkansas | $212.50 | — |
| ArizonaArizona | $223.38 | — |
| Bakersfield, CACalifornia | $238.16 | — |
| Chico, CACalifornia | $237.88 | — |
| El Centro, CACalifornia | $237.88 | — |
| Fresno, CACalifornia | $237.88 | — |
| Hanford, CACalifornia | $237.88 | — |
| Madera, CACalifornia | $237.88 | — |
| Merced, CACalifornia | $237.88 | — |
| Modesto, CACalifornia | $237.88 | — |
| Napa, CACalifornia | $265.50 | — |
| Oxnard, CACalifornia | $247.73 | — |
| Redding, CACalifornia | $237.88 | — |
| Rest of CaliforniaCalifornia | $237.88 | — |
| Riverside, CACalifornia | $238.11 | — |
| Sacramento, CACalifornia | $246.87 | — |
| Salinas, CACalifornia | $245.84 | — |
| San Diego, CACalifornia | $249.33 | — |
| Marin County, CACalifornia | $278.59 | — |
| San Francisco, CACalifornia | $278.58 | — |
| San Benito County, CACalifornia | $283.67 | — |
| Santa Clara County, CACalifornia | $283.62 | — |
| San Luis Obispo, CACalifornia | $242.09 | — |
| Santa Cruz, CACalifornia | $250.04 | — |
| Santa Maria, CACalifornia | $246.14 | — |
| Santa Rosa, CACalifornia | $252.46 | — |
| Stockton, CACalifornia | $237.88 | — |
| Vallejo, CACalifornia | $265.48 | — |
| Visalia, CACalifornia | $237.88 | — |
| Yuba City, CACalifornia | $237.88 | — |
| ConnecticutConnecticut | $236.63 | — |
| DelawareDelaware | $225.89 | — |
| Fort Lauderdale, FLFlorida | $228.00 | — |
| Rest of FloridaFlorida | $222.32 | — |
| Atlanta, GAGeorgia | $228.48 | — |
| Rest of GeorgiaGeorgia | $215.95 | — |
| Hawaii, Guam, HIHawaii | $239.72 | — |
| IowaIowa | $217.94 | — |
| IdahoIdaho | $218.45 | — |
| East St. Louis, ILIllinois | $218.97 | — |
| Rest of IllinoisIllinois | $218.13 | — |
| Suburban Chicago, ILIllinois | $230.26 | — |
| IndianaIndiana | $219.14 | — |
| KansasKansas | $216.90 | — |
| KentuckyKentucky | $215.57 | — |
| New Orleans, LALouisiana | $220.73 | — |
| Rest of LouisianaLouisiana | $215.19 | — |
| Metropolitan Boston, MAMassachusetts | $250.67 | — |
| Rest of MassachusettsMassachusetts | $233.63 | — |
| Baltimore area, MDMaryland | $235.73 | — |
| Rest of MarylandMaryland | $228.89 | — |
| Rest of MaineMaine | $218.50 | — |
| Southern Maine, MEMaine | $225.45 | — |
| Detroit, MIMichigan | $223.26 | — |
| Rest of MichiganMichigan | $217.99 | — |
| MinnesotaMinnesota | $229.06 | — |
| Metropolitan Kansas City, MOMissouri | $220.48 | — |
| Metropolitan St. Louis, MOMissouri | $221.76 | — |
| Rest of MissouriMissouri | $212.94 | — |
| MississippiMississippi | $212.77 | — |
| MontanaMontana | $226.46 | — |
| North CarolinaNorth Carolina | $219.78 | — |
| North DakotaNorth Dakota | $226.26 | — |
| NebraskaNebraska | $218.71 | — |
| New HampshireNew Hampshire | $230.43 | — |
| Northern New JerseyNew Jersey | $250.22 | — |
| Rest of New JerseyNew Jersey | $240.62 | — |
| New MexicoNew Mexico | $218.40 | — |
| NevadaNevada | $226.50 | — |
| NYC suburbs and Long Island, NYNew York | $253.45 | — |
| Poughkeepsie and northern NYC suburbs, NYNew York | $241.60 | — |
| Queens, NYNew York | $252.63 | — |
| Rest of New YorkNew York | $221.47 | — |
| OhioOhio | $217.95 | — |
| OklahomaOklahoma | $215.91 | — |
| Portland, OROregon | $239.29 | — |
| Rest of OregonOregon | $225.97 | — |
| Metropolitan Philadelphia, PAPennsylvania | $232.84 | — |
| Rest of PennsylvaniaPennsylvania | $218.41 | — |
| Puerto RicoPuerto Rico | $227.53 | — |
| Rhode IslandRhode Island | $232.09 | — |
| South CarolinaSouth Carolina | $218.97 | — |
| South DakotaSouth Dakota | $226.24 | — |
| TennesseeTennessee | $217.40 | — |
| Austin, TXTexas | $232.35 | — |
| Beaumont, TXTexas | $217.63 | — |
| Brazoria, TXTexas | $226.53 | — |
| Dallas, TXTexas | $227.17 | — |
| Fort Worth, TXTexas | $226.20 | — |
| Galveston, TXTexas | $226.74 | — |
| Houston, TXTexas | $226.92 | — |
| Rest of TexasTexas | $221.43 | — |
| UtahUtah | $220.55 | — |
| VirginiaVirginia | $224.70 | — |
| Virgin Islands, VIUnited States Virgin Islands | $227.53 | — |
| VermontVermont | $225.31 | — |
| Rest of WashingtonWashington | $233.23 | — |
| King County, WAWashington | $255.03 | — |
| WisconsinWisconsin | $222.12 | — |
| West VirginiaWest Virginia | $213.78 | — |
| WyomingWyoming | $226.37 | — |
92523 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
$212.50
$296.80
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $296.80 | 1 |
| AL | $214.08 | 1 |
| AR | $212.50 | 1 |
| AZ | $223.38 | 1 |
| CA | $237.88–$283.67 | 29 |
| CO | $234.19 | 1 |
| CT | $236.63 | 1 |
| DC | $250.84 | 1 |
| DE | $225.89 | 1 |
| FL | $222.32–$230.98 | 3 |
| GA | $215.95–$228.48 | 2 |
| GU | $239.72 | 1 |
| HI | $239.72 | 1 |
| IA | $217.94 | 1 |
| ID | $218.45 | 1 |
| IL | $218.13–$230.26 | 4 |
| IN | $219.14 | 1 |
| KS | $216.90 | 1 |
| KY | $215.57 | 1 |
| LA | $215.19–$220.73 | 2 |
| MA | $233.63–$250.67 | 2 |
| MD | $228.89–$250.84 | 3 |
| ME | $218.50–$225.45 | 2 |
| MI | $217.99–$223.26 | 2 |
| MN | $229.06 | 1 |
| MO | $212.94–$221.76 | 3 |
| MS | $212.77 | 1 |
| MT | $226.46 | 1 |
| NC | $219.78 | 1 |
| ND | $226.26 | 1 |
| NE | $218.71 | 1 |
| NH | $230.43 | 1 |
| NJ | $240.62–$250.22 | 2 |
| NM | $218.40 | 1 |
| NV | $226.50 | 1 |
| NY | $221.47–$253.45 | 5 |
| OH | $217.95 | 1 |
| OK | $215.91 | 1 |
| OR | $225.97–$239.29 | 2 |
| PA | $218.41–$232.84 | 2 |
| PR | $227.53 | 1 |
| RI | $232.09 | 1 |
| SC | $218.97 | 1 |
| SD | $226.24 | 1 |
| TN | $217.40 | 1 |
| TX | $217.63–$232.35 | 8 |
| UT | $220.55 | 1 |
| VA | $224.70–$250.84 | 2 |
| VI | $227.53 | 1 |
| VT | $225.31 | 1 |
| WA | $233.23–$255.03 | 2 |
| WI | $222.12 | 1 |
| WV | $213.78 | 1 |
| WY | $226.37 | 1 |
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.
The exact Colorado inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
11,790
- Code
- 92523
- Physician work
- 3.84
- Practice expense
- 2.93
- Malpractice
- 0.01
GPCI2026.csv
37
- Locality
- Colorado
- Physician work
- 1.012
- Practice expense
- 1.064
- Malpractice
- 0.781
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.84 | × 1.012 | 3.8861 |
| Practice expense | 2.93 | × 1.064 | 3.1175 |
| Malpractice | 0.01 | × 0.781 | 0.0078 |
| Total RVUs | 7.0114 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Colorado$234.19
Office: (3.84 × 1.012 + 2.93 × 1.064 + 0.01 × 0.781) × $33.4009 = $234.19
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.
How 92523 has changed in Colorado
92523 · Office / nonfacility
$234.19
Effective 2026-10-01
The base rate is $5.15 higher than on 2025-10-01, moving from $229.04 to $234.19 (2.2%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
January 1, 2026
RVU26A
$229.04changed to$234.19
- Conversion factor 32.3465 changed to 33.4009
- Practice expense RVU 2.97 changed to 2.93
- Malpractice RVU 0.10 changed to 0.01
- Work GPCI 1.008 changed to 1.012
- Practice expense GPCI 1.053 changed to 1.064
- Malpractice GPCI 0.827 changed to 0.781
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$233.25changed to$229.04
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 2.90 changed to 2.97
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$229.44changed to$233.25
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$234.89changed to$229.44
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 2.85 changed to 2.90
- Work GPCI 1.005 changed to 1.008
- Practice expense GPCI 1.050 changed to 1.053
- Malpractice GPCI 0.797 changed to 0.827
January 1, 2023
RVU23A
$235.12changed to$234.89
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 2.73 changed to 2.85
- Malpractice RVU 0.12 changed to 0.10
- Work GPCI 1.001 changed to 1.005
- Practice expense GPCI 1.047 changed to 1.050
- Malpractice GPCI 0.767 changed to 0.797
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$238.60changed to$235.12
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 2.75 changed to 2.73
- Malpractice RVU 0.15 changed to 0.12
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$200.96changed to$238.60
- Conversion factor 36.0896 changed to 34.8931
- Work RVU 3.00 changed to 3.84
- Practice expense RVU 2.39 changed to 2.75
- Malpractice RVU 0.11 changed to 0.15
- Work GPCI 1.000 changed to 1.001
- Practice expense GPCI 1.033 changed to 1.047
- Malpractice GPCI 0.905 changed to 0.767
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$201.40changed to$200.96
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 2.43 changed to 2.39
- Practice expense GPCI 1.018 changed to 1.033
- Malpractice GPCI 1.042 changed to 0.905
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$203.38changed to$201.40
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 2.49 changed to 2.43
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$200.77changed to$203.38
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 2.43 changed to 2.49
- Malpractice RVU 0.12 changed to 0.11
- Practice expense GPCI 1.015 changed to 1.018
- Malpractice GPCI 1.066 changed to 1.042
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$197.19changed to$200.77
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 2.34 changed to 2.43
- Malpractice RVU 0.13 changed to 0.12
- Practice expense GPCI 1.011 changed to 1.015
- Malpractice GPCI 1.090 changed to 1.066
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$191.78changed to$197.19
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 2.15 changed to 2.34
- Malpractice RVU 0.15 changed to 0.13
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$190.83changed to$191.78
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$193.34changed to$190.83
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 2.31 changed to 2.15
- Malpractice RVU 0.07 changed to 0.15
- Practice expense GPCI 1.008 changed to 1.011
- Malpractice GPCI 0.981 changed to 1.090
Held through RVU15B.
January 1, 2014
RVU14A
No ratechanged to$193.34
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $234.19 | Not available in this setting | RVU26D |
| 2026-07-01 | $234.19 | Not available in this setting | RVU26C |
| 2026-04-01 | $234.19 | Not available in this setting | RVU26B |
| 2026-01-01 | $234.19 | Not available in this setting | RVU26A |
| 2025-10-01 | $229.04 | Not available in this setting | RVU25D |
| 2025-07-01 | $229.04 | Not available in this setting | RVU25C |
| 2025-04-01 | $229.04 | Not available in this setting | RVU25B |
| 2025-01-01 | $229.04 | Not available in this setting | RVU25A |
| 2024-10-01 | $233.25 | Not available in this setting | RVU24D |
| 2024-07-01 | $233.25 | Not available in this setting | RVU24C |
| 2024-04-01 | $233.25 | Not available in this setting | RVU24B |
| 2024-03-09 | $233.25 | Not available in this setting | RVU24AR |
| 2024-01-01 | $229.44 | Not available in this setting | RVU24A |
| 2023-10-01 | $234.89 | Not available in this setting | RVU23D |
| 2023-07-01 | $234.89 | Not available in this setting | RVU23C |
| 2023-04-01 | $234.89 | Not available in this setting | RVU23B |
| 2023-01-01 | $234.89 | Not available in this setting | RVU23A |
| 2022-10-01 | $235.12 | Not available in this setting | RVU22D |
| 2022-07-01 | $235.12 | Not available in this setting | RVU22C |
| 2022-04-01 | $235.12 | Not available in this setting | RVU22B |
| 2022-01-01 | $235.12 | Not available in this setting | RVU22A |
| 2021-10-01 | $238.60 | Not available in this setting | RVU21D |
| 2021-07-01 | $238.60 | Not available in this setting | RVU21C |
| 2021-04-01 | $238.60 | Not available in this setting | RVU21B |
| 2021-01-01 | $238.60 | Not available in this setting | RVU21A |
| 2020-10-01 | $200.96 | Not available in this setting | RVU20D |
| 2020-07-01 | $200.96 | Not available in this setting | RVU20C |
| 2020-04-01 | $200.96 | Not available in this setting | RVU20B |
| 2020-01-01 | $200.96 | Not available in this setting | RVU20A |
| 2019-10-01 | $201.40 | Not available in this setting | RVU19D |
| 2019-07-01 | $201.40 | Not available in this setting | RVU19C |
| 2019-04-01 | $201.40 | Not available in this setting | RVU19B |
| 2019-01-01 | $201.40 | Not available in this setting | RVU19A |
| 2018-10-01 | $203.38 | Not available in this setting | RVU18D |
| 2018-07-01 | $203.38 | Not available in this setting | RVU18C |
| 2018-04-01 | $203.38 | Not available in this setting | RVU18B |
| 2018-01-01 | $203.38 | Not available in this setting | RVU18AR1 |
| 2017-10-01 | $200.77 | Not available in this setting | RVU17D |
| 2017-07-01 | $200.77 | Not available in this setting | RVU17C |
| 2017-04-01 | $200.77 | Not available in this setting | RVU17B |
| 2017-01-01 | $200.77 | Not available in this setting | RVU17A |
| 2016-10-01 | $197.19 | Not available in this setting | RVU16D |
| 2016-07-01 | $197.19 | Not available in this setting | RVU16C |
| 2016-04-01 | $197.19 | Not available in this setting | RVU16B |
| 2016-01-01 | $197.19 | Not available in this setting | RVU16A |
| 2015-10-01 | $191.78 | Not available in this setting | RVU15D |
| 2015-07-01 | $191.78 | Not available in this setting | RVU15C |
| 2015-04-01 | $190.83 | Not available in this setting | RVU15B |
| 2015-01-01 | $190.83 | Not available in this setting | RVU15A |
| 2014-10-01 | $193.34 | Not available in this setting | RVU14D |
| 2014-07-01 | $193.34 | Not available in this setting | RVU14C |
| 2014-04-01 | $193.34 | Not available in this setting | RVU14B |
| 2014-01-01 | $193.34 | Not available in this setting | RVU14A |
| 2013-10-01 | Not in this release | Not in this release | RVU13D |
| 2013-07-01 | Not in this release | Not in this release | RVU13C |
| 2013-04-01 | Not in this release | Not in this release | RVU13B |
| 2013-01-01 | Not in this release | Not in this release | RVU13AR |
Where the Colorado rate applies
Colorado is a Medicare payment area, not a city. Our Census mapping connects it to 485 cities and communities in Colorado. Some span more than one payment area; confirm with the service ZIP.
- Acres Green
- Aetna Estates
- Aguilar
- Air Force Academy
- Akron
- Alamosa
- Alamosa East
- Allenspark
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
Fee sheets
Put 92523 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
Build my fee sheet