CPT code 92526: Swallowing therapy, oral feeding function2026 Medicare rate & RVUs in Missouri

Skilled therapy for swallowing dysfunction or oral feeding impairment, reported when treatment addresses the patient’s swallowing or feeding function.

CMS RVU26DEffective Oct 1, 20263 payment localities284.1K Medicare services in 2024

Medicare pays $78.77–$82.30 for 92526 in the office in Missouri, from Rest of Missouri to Metropolitan St. Louis, MO. Which amount applies depends on the service address.

$78.77–$82.30Office (non-facility)
—Hospital or facility

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

Your location

Medicare pays by the payment locality where the service is performed.

On this page 9 sections
  1. Rate in Missouri
  2. What 92526 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 92526 covers

92526 represents skilled therapeutic intervention for impaired swallowing or oral function used for feeding. A speech-language pathologist commonly provides it for dysphagia after stroke, neurologic disease, or head and neck treatment, and for children with feeding-related oral-motor difficulty. Treatment may include swallowing practice, compensatory strategies, and exercises selected for the patient’s functional deficits. This is therapy, not a swallowing evaluation or an instrumental study, and may be provided in outpatient or facility settings.

Report the service for a treatment session, with documentation of the swallowing or feeding problem, skilled interventions, goals, and the patient’s response. It is generally an untimed service, reported as one unit per session rather than in 15-minute increments. CMS treats it as a therapy service, so a professional component modifier does not apply. When it is among multiple therapy services on the same day, the practice expense for the second and later therapy units is reduced under the therapy multiple procedure payment reduction.

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 92526 pays more and less in Missouri

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

3 payment localities

$78.77 to $82.30

$78.77$80.53$82.30
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.
92526 office and facility rates by payment locality
Payment localityOfficeFacility
Metropolitan Kansas City, MO$81.78Unavailable
Metropolitan St. Louis, MO$82.30Unavailable
Rest of Missouri$78.77Unavailable

How the 92526 rate is calculated

Each of 92526’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 · 92526

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.34

1.34 RVUs× 1.000 GPCI

Practice expense1.17

1.17 RVUs× 1.000 GPCI

Malpractice0.01

0.01 RVUs× 1.000 GPCI

Adjusted RVUs

2.5200

Conversion factor

$33.4009

Medicare rate

$84.17

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 92526

The CMS indicators that decide how 92526 is paid alongside other services.

CMS payment indicators · 92526

Swallowing therapy, oral feeding function

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
Multiple procedures5Therapy reduction: practice expense of the second and later units is reduced.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical7Therapy service: the split doesn’t apply.

What modifiers do to the payment

Modifier CQ · payment effect

With and without the modifier

92526 without CQ · national office

$84.17

Swallowing therapy, oral feeding function

92526-CQ · Allowed amount unchanged

$84.17

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.

92526 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 92526

    Swallowing therapy, oral feeding function1.34 wRVU

    $84.17

  • 92507

    Speech therapy, individual session1.3 wRVU

    $76.15−$8.02

  • 92610

    Swallow evaluation, clinical, noninstrumental assessment1.3 wRVU

    $84.84+$0.67

  • 92611

    Swallow study, fluoroscopic evaluation1.31 wRVU

    $91.52+$7.35

How to choose

92507Speech therapyIndividual session
92507 is treatment for speech, language, voice, or communication goals. Use 92526 for treatment directed at swallowing dysfunction or oral function for feeding.
92610Swallow evaluationClinical, noninstrumental assessment
92610 reports a clinical swallowing evaluation; 92526 reports skilled treatment. The service performed, not just the diagnosis, determines the choice.
92611Swallow studyFluoroscopic evaluation
92611 is a videofluoroscopic swallowing evaluation. It documents swallowing function through imaging, whereas 92526 reports therapeutic intervention.

92526 billing questions

How is 92526 different from 92507?

Use 92526 when skilled treatment targets swallowing or oral function for feeding. Use 92507 when the treatment targets speech, language, voice, or communication.

Is 92526 an evaluation code?

No. It reports treatment. Code 92610 is used for a clinical evaluation of oral and pharyngeal swallowing function.

Can modifier 26 be appended?

No. CMS identifies 92526 as a therapy service without a professional component modifier.

Is the service billed in 15-minute units?

No. It is generally reported as one unit per treatment session, not in 15-minute increments.

What happens when multiple therapy services are billed on the same day?

CMS reduces practice expense for the second and later therapy units on that day. The reduction applies when 92526 falls among those later units.

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
RVUs for 92526PPRRVU2026_Oct_nonQPP.csv, line 11,792 (RVU26D)

Open CMS sourceHow we calculate rates

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