92522 addresses speech sound production alone. Choose 92523 when receptive and expressive language are also evaluated.
On this page
CMS RVU26D · Effective 2026-10-01
92523 Speech-language evaluation Medicare reimbursement rates in Pennsylvania
A speech-language pathologist evaluates speech sound production together with receptive and expressive language to characterize combined communication concerns. Compare 92523 office and facility rates across CMS payment localities in Pennsylvania.
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 92523 in Pennsylvania?
Pennsylvania has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$218.41–$232.84
2 of 2 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.
Speech-language pathology
About 92523: Speech sound and language evaluation
A speech-language pathologist evaluates speech sound production together with receptive and expressive language to characterize combined communication concerns.
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.
CMS billing rules for 92523
- 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 RVU3.84 · 57%
- Practice expense (office) RVU2.93 · 43%
- Malpractice RVU0.01 · 0%
42.7K
Medicare services in 2024 · #841 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.
92523 compared with similar codes
Office rates for Pennsylvania, from the same CMS release.
92521 focuses on fluency concerns such as stuttering; 92523 combines speech sound production and language assessment.
92524 evaluates voice characteristics and function. It is not the combined speech sound and language assessment represented by 92523.
Compare 92523 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.
2 of 2 payment localities
Metropolitan Philadelphia →
Office / nonfacility
$232.84
Facility
Unavailable
Rest Of Pennsylvania →
Office / nonfacility
$218.41
Facility
Unavailable
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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 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.
