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CPT code 92609: Speech device therapy, programming and use training2026 Medicare rate & RVUs

Speech-language pathologists report this therapy for skilled training in using a speech-generating communication device, including device programming and modification.

CMS RVU26DEffective Oct 1, 2026109 payment localities16.6K Medicare services in 2024

Medicare pays $102.54 for 92609 nationally in the office. Local office rates run $95.03–$130.93.

Medicare rate · 92609

Speech device therapy, programming and use training

Office or facility?

Work RVUs
1.5
Total RVUs
3.07
Global days
XXX

National rate · 2026

$102.54

Office setting, before claim adjustments.

See every locality for 92609 →Billed by an NP, PA or therapist? →

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 10 sections
  1. Medicare rate
  2. What 92609 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 92609 covers

A speech-language pathologist uses this service to help a person communicate with a speech-generating device, such as an augmentative and alternative communication system that produces spoken output. The work may include teaching the patient to operate the device, adapting its vocabulary or settings to support communication, and modifying programming as communication needs change. Services are typically furnished in outpatient therapy settings, including clinics and offices, and may involve caregiver instruction when it supports the patient’s device use.

Report 92609 for skilled therapeutic work with the speech-generating device, not for evaluating whether a device should be prescribed. The record should identify the device and describe the skilled training, programming, or modifications performed and their connection to the patient’s communication goals. The CMS therapy multiple procedure payment reduction decreases the practice expense portion for the second and later therapy units on the same day. The professional component modifier does not apply to this therapy service.

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 92609 pays more and less

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

109 payment localities

$95.03 to $130.93

$95.03$112.98$130.93
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.

109 of 109 payment localities

92609 office and facility rates by payment locality
Payment localityOfficeFacility
Alabama$95.88Unavailable
Alaska$130.83Unavailable
Arizona$100.88Unavailable
Arkansas$95.03Unavailable
Atlanta, GA$103.59Unavailable
Austin, TX$105.63Unavailable
Bakersfield, CA$108.36Unavailable
Baltimore area, MD$107.23Unavailable
Beaumont, TX$97.83Unavailable
Brazoria, TX$102.40Unavailable

92609 rates by state

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

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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.

$95.03

$130.83

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
92609 office rate range by state
State / territoryOffice rate rangeLocalities
AK$130.831
AL$95.881
AR$95.031
AZ$100.881
CA$108.24–$130.9329
CO$106.401
CT$107.631
DC$114.561
DE$102.131
FL$100.42–$105.193
GA$96.98–$103.592
GU$109.541
HI$109.541
IA$97.911
ID$98.201
IL$98.20–$104.564
IN$98.571
KS$97.371
KY$96.731
LA$96.53–$99.512
MA$106.04–$114.672
MD$103.64–$114.563
ME$98.25–$101.952
MI$98.05–$100.952
MN$103.821
MO$95.34–$100.043
MS$95.211
MT$102.541
NC$98.931
ND$102.341
NE$98.321
NH$104.641
NJ$109.37–$114.062
NM$98.281
NV$102.541
NY$99.84–$115.885
OH$98.011
OK$96.891
OR$102.23–$109.042
PA$98.25–$105.642
PR$103.111
RI$105.181
SC$98.531
SD$102.321
TN$97.641
TX$97.83–$105.638
UT$99.381
VA$101.56–$114.562
VI$103.111
VT$101.851
WA$105.87–$116.812
WI$100.121
WV$95.861
WY$102.451

How the 92609 rate is calculated

Each of 92609’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 · 92609

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.50

1.50 RVUs× 1.000 GPCI

Practice expense1.56

1.56 RVUs× 1.000 GPCI

Malpractice0.01

0.01 RVUs× 1.000 GPCI

Adjusted RVUs

3.0700

Conversion factor

$33.4009

Medicare rate

$102.54

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

Payment rules and modifiers for 92609

The CMS indicators that decide how 92609 is paid alongside other services.

CMS payment indicators · 92609

Speech device therapy, programming and use training

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

92609 without CQ · national office

$102.54

Speech device therapy, programming and use training

92609-CQ · Allowed amount unchanged

$102.54

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.

92609 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 92609

    Speech device therapy, programming and use training1.5 wRVU

    $102.54

  • 92607

    AAC evaluation, prescription assessment, first hour1.85 wRVU

    $122.25+$19.71

  • 92606

    AAC device therapy, non-speech-generating1.37 wRVU

    Not priced

  • 92602

    Implant reprogramming, subsequent, under age 71.3 wRVU

    $97.20−$5.34

How to choose

92607AAC evaluationPrescription assessment, first hour
Choose 92607 for evaluating the patient to support a speech-generating device prescription; choose 92609 for therapeutic use, programming, or modification.
92606AAC device therapyNon-speech-generating
92606 concerns therapeutic use of a non-speech-generating device. 92609 concerns a device that generates speech output.
92602Implant reprogrammingSubsequent, under age 7
92602 is for reprogramming a cochlear implant for a child under age 7. 92609 is therapy involving a speech-generating communication device.

Codes related to 92609

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

Codes related to 92609
CodeHow it relatesNational office range
Often billed with
92607AAC evaluation, prescription assessment, first hourA distinct evaluation for a speech-generating device prescription may accompany therapeutic device-use services.$113.61–$156.90
92608Speech device evaluation, each additional 30 minutesAdditional evaluation time for the speech-generating device prescription evaluation reported with 92607.$44.33–$61.11
Used instead
92606AAC device therapy, non-speech-generatingTherapeutic service for a non-speech-generating device rather than a speech-generating device.No office rate

92609 billing questions

How does 92609 differ from 92607?

92607 is for evaluating a patient to support a speech-generating device prescription. Use 92609 for therapeutic work on using, programming, or modifying the device.

Can evaluation and device therapy be reported together?

They describe different services. Report both only when the record supports a distinct prescription evaluation and therapeutic device service.

Does 92609 cover programming changes?

Yes. Programming and modification can be part of the skilled therapeutic service when performed to support the patient’s use of the speech-generating device.

Should a professional component modifier be appended?

No. CMS identifies 92609 as a therapy service for which the professional component modifier does not apply.

How does the same-day therapy reduction affect this code?

For the second and later therapy units on the same day, CMS reduces the practice expense portion of payment.

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 92609PPRRVU2026_Oct_nonQPP.csv, line 11,867 (RVU26D)

Open CMS sourceHow we calculate rates

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