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Speech Therapy

Speech Therapy Billing: Codes, Common Denials, and How to Fix Them

Speech therapy billing works differently from OT and PT. Many core SLP codes are untimed, evaluations are split by type, and pediatric practices lean heavily on Medicaid. Here is what speech therapy practice owners should understand.

By Brandon Seigel, Chief Problem Solver · August 18, 2026 · 7 min read

The core SLP codes

Most speech therapy practices bill from this group:

  • 92507 — Treatment of speech, language, voice, communication, or auditory processing
  • 92521 — Evaluation of speech fluency
  • 92522 — Evaluation of speech sound production
  • 92523 — Evaluation of speech sound production with language comprehension and expression
  • 92524 — Behavioral and qualitative analysis of voice and resonance
  • 92526 — Treatment of swallowing dysfunction and/or oral function for feeding

Untimed codes change the math

92507 is untimed. It is billed once per session regardless of length, for most payers. Some Medicaid plans and commercial payers set their own unit rules, which is why knowing your payer contracts matters.

Billing 92507 with multiple units when the payer expects one is a common and avoidable denial.

Pediatric speech and Medicaid

Pediatric speech practices often depend on Medicaid and managed Medicaid. Authorizations, re-authorizations, and plan changes happen constantly. When an authorization lapses, visits keep happening — but payment doesn't.

The fix is a daily authorization and eligibility process, with clear handoffs between your front desk and your billing team.

Denials SLP practices see most

  • Authorization missing, expired, or visits exhausted
  • Incorrect units on untimed codes
  • Evaluation code doesn't match documentation
  • Diagnosis codes not supporting medical necessity
  • Patient eligibility changed mid-month

Quick answers

Is CPT 92507 a timed code?

No. 92507 is an untimed code and is typically billed once per session, though some payers set their own unit rules.

What is the difference between 92522 and 92523?

92522 evaluates speech sound production only. 92523 evaluates speech sound production plus language comprehension and expression.

See exactly what's included in our medical billing services for therapy practices, how our percentage-of-collections pricing works, or browse common questions from practice owners.

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