$105.45–$109.67
Choose 92521 for a fluency assessment, such as evaluation of stuttering. Choose 92522 when the assessment centers on speech sound production.
On this page
CMS RVU26D · Effective 2026-10-01
92521 Speech evaluation Medicare reimbursement rates in Missouri
A speech-language pathologist evaluates fluency problems such as stuttering or cluttering to characterize communication difficulties and guide care. Compare 92521 office and facility rates across CMS payment localities in Missouri.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 92521 in Missouri?
Missouri has 3 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 3 payment areas shown below, using the same CMS release.
Office / nonfacility
$125.24–$130.48
3 of 3 localities have a supported rate.
Facility setting
No supported rate
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 92521 pays more and less in Missouri
3 payment localities
$125.24 to $130.48
Speech-language pathology
About 92521: Speech fluency disorder evaluation
A speech-language pathologist evaluates fluency problems such as stuttering or cluttering to characterize communication difficulties and guide care.
A speech-language pathologist uses this service to assess fluency problems, including stuttering or cluttering. The evaluation may include conversation and structured speaking tasks, with attention to disruptions such as repetitions, prolongations, or blocks and how they affect communication. It is distinct from assessment focused on speech sound production, language, or voice. These evaluations are commonly performed in outpatient speech-language pathology settings.
Report the service when the evaluation centers on fluency rather than another speech or language domain. Documentation should describe the assessment methods, observed fluency behaviors, their impact on communication, and clinical conclusions or recommendations. CMS treats this as a therapy service, not as separate professional and technical portions, so a professional-component modifier is not used. When multiple therapy services are billed on the same day, CMS reduces practice-expense payment for the second and later therapy units under the therapy multiple-procedure payment rule.
CMS billing rules for 92521
- Professional and technical components
- Therapy service: the professional component modifier does not apply.
- Multiple procedures
- Therapy multiple procedure payment reduction: practice expense is reduced for the second and later therapy units on the same day.
Where the value comes from
- Work RVU2.24 · 56%
- Practice expense (office) RVU1.74 · 44%
- Malpractice RVU0.01 · 0%
490
Medicare services in 2024 · #3587 by national volume
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.
92521 compared with similar codes
Office rates for Missouri, from the same CMS release.
$212.94–$221.76
92523 covers speech sound production together with language comprehension and expression; 92521 focuses on fluency.
$103.40–$107.42
92524 assesses voice quality and related vocal characteristics. 92521 is for evaluation of speech fluency.
Compare 92521 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
3 of 3 payment localities
Metropolitan Kansas City →
Office / nonfacility
$129.72
Facility
Unavailable
Metropolitan St. Louis →
Office / nonfacility
$130.48
Facility
Unavailable
Rest Of Missouri →
Office / nonfacility
$125.24
Facility
Unavailable
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92521 billing questions
When should 92521 be chosen instead of 92522?
Use 92521 when the evaluation focuses on fluency disruptions such as stuttering or cluttering. Use 92522 when the primary focus is speech sound production.
How does 92521 differ from 92523?
92521 assesses fluency. 92523 addresses speech sound production together with language comprehension and expression.
Can 92521 be reported with a professional-component modifier?
No. CMS identifies 92521 as a therapy service without separate professional and technical components.
What documentation supports reporting 92521?
Document the fluency assessment methods, observed behaviors, communication impact, and clinical findings or recommendations. The record should show that fluency was the evaluation focus.
What happens when other therapy services are billed the same day?
CMS reduces practice-expense payment for the second and later therapy units under its therapy multiple-procedure payment rule.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
11,78592518,,Vemp test i&r ocular,A,,0.78,1.43,,0.22,,0.04,2.25,1.04,0,XXX,0.00,0.00,0.00,0,2,0,0,0,9,,33.4009,02,0,99,0.00,0.00,0.00
11,78692519,,Vemp tst i&r cervical&ocular,A,,1.17,2.32,,0.33,,0.03,3.52,1.53,0,XXX,0.00,0.00,0.00,0,2,0,0,0,9,,33.4009,02,0,99,0.00,0.00,0.00
11,78792520,,Laryngeal function studies,A,,0.73,1.97,,0.22,,0.02,2.72,0.97,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,78892521,,Evaluation of speech fluency,A,,2.24,1.74,,1.74,NA,0.01,3.99,3.99,7,XXX,0.00,0.00,0.00,5,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,78992522,,Evaluate speech production,A,,1.92,1.39,,1.39,NA,0.04,3.35,3.35,7,XXX,0.00,0.00,0.00,5,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,79092523,,Speech sound lang comprehen,A,,3.84,2.93,,2.93,NA,0.01,6.78,6.78,7,XXX,0.00,0.00,0.00,5,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,79192524,,Behavral qualit analys voice,A,,1.92,1.33,,1.33,NA,0.03,3.28,3.28,7,XXX,0.00,0.00,0.00,5,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00