For as long as most speech-language pathologists have been billing insurance, individual speech and language treatment has been one code: CPT 92507. One code, billed once per session, regardless of whether the session was 25 minutes or 55, and regardless of whether the child was working on articulation, language, fluency, or voice.
That ends on January 1, 2027. CPT 92507 is deleted from the CPT code set, and individual treatment is reported with a new family of ten time-based codes organized by what is being treated. Group treatment stays on 92508. For practices, this isn't just a code swap. It changes how sessions are documented, how units are counted, what the EHR needs to capture, and how payer contracts and fee schedules are written.
The new codes
Each clinical category has a base code for the first 30 minutes of direct, one-on-one treatment and an add-on code for each additional 15 minutes. The add-on can never be billed alone.
| What is being treated | Base code (first 30 min) | Add-on (each addl. 15 min) |
|---|---|---|
| Fluency (stuttering, cluttering) | 92654 | +92655 |
| Speech sound production (articulation, phonological, apraxia, dysarthria) | 92656 | +92657 |
| Language comprehension and expression | 92658 | +92659 |
| Combined speech sound and language | 92660 | +92661 |
| Voice, upper airway, and/or resonance | 92662 | +92663 |
| Group treatment (2 or more individuals) | 92508 (untimed, unchanged structure) | |
ASHA's published guidance used placeholder numbers (92X0X through 92X9X) until the 2027 CPT code set was released. The numbers above are the ones circulating in the speech therapy billing community since that release. Confirm them against the AMA's 2027 CPT codebook, and against each payer's fee schedule, before you load them into your EHR.
How time and units work
The biggest operational change is that treatment is now timed. Per ASHA's guidance, the codes follow CPT's midpoint convention:
| Direct one-on-one time | What to report |
|---|---|
| Under 16 minutes | Not reportable with the base code |
| 16–37 minutes | Base code × 1 |
| 38–52 minutes | Base code × 1 + add-on × 1 |
| 53–67 minutes | Base code × 1 + add-on × 2 |
| 68–82 minutes | Base code × 1 + add-on × 3 |
Example: a 55-minute language session is reported as 92658 × 1 and 92659 × 2. A 48-minute session is 92658 × 1 and 92659 × 1. Time spent on other services, such as an evaluation or a swallowing treatment on the same day, can't be counted toward these codes.
Coding rules to build into your templates
- Don't combine speech sound and language codes. When both are treated in the same session, use the combined codes (92660/92661), not 92656 plus 92658.
- Don't report the combined codes with the separate speech or language codes on the same date.
- Different categories on the same day are allowed if each is distinct, medically necessary, and meets its own time requirement (for example, fluency and voice treatment in separate time blocks).
- Watch the ABA overlaps. The new treatment codes shouldn't be reported with 97153 or 97155, and 92508 shouldn't be reported with 97154 or 97158. This matters for multidisciplinary pediatric practices.
- Expect NCCI and MUE edits. CMS publishes edits for new codes that can limit same-day combinations and units. Review them when they're released and update your claim scrubber.
What to change before January 1
1. Documentation
Under 92507, many notes recorded the session, the goals, and the outcome, but not minutes. Under the new codes, the note has to show the clinical category treated and the direct one-on-one minutes for each service. If two categories are treated, the time for each has to be separate so the same minutes aren't counted twice. Update templates now and give therapists a few weeks of practice before it's required.
2. Your EHR and claim setup
Load the new codes, set them up as timed services, and retire 92507 for dates of service on or after January 1, 2027. If your EHR uses session "types" that map to a single CPT code, you'll likely need new types or a way to pick the category and minutes per session. In SimplePractice, PracticeQ, Tebra, and similar systems, this is a settings change, but it has to be done before the first January claims go out. (We cover how the major systems handle insurance billing in this guide to EHR billing.)
3. Fee schedule and charges
Your charge master needs a fee for each base and add-on code. Since a long session now produces more than one line, a flat per-session fee no longer maps cleanly. Set charges at or above your highest contracted rate for each code.
4. Payer contracts
If a commercial contract or a Medicaid managed care agreement names 92507 explicitly, ask the payer how it will crosswalk the rate and when it will accept the new codes. Medicare values the new codes through the physician fee schedule. Medicaid programs and commercial plans set their own adoption dates and rates and aren't required to follow Medicare. Some may keep accepting 92507 for a period. Get the answer in writing for each payer that matters.
5. Authorizations that span the switch
If a patient's prior authorization was approved for "92507 × 24 visits" through March 2027, find out whether the payer will honor it for the new codes or require a new request. Authorizations that straddle January 1 are where early-2027 denials will come from.
6. Regional center and Medi-Cal work
Regional center invoices are billed by service code and units, not CPT, so the switch doesn't change the invoice itself. But regional centers expect insurance or Medi-Cal to be billed first. If those claims start denying in January because of the code change, the regional center coordination stalls with them. Watch early-2027 denials closely. (See our regional center billing guide for how that coordination works.)
What doesn't change
The speech and language evaluation codes, 92521 (fluency), 92522 (speech sound production), 92523 (speech sound production with language comprehension and expression), and 92524 (voice and resonance), aren't part of this change. Neither are swallowing and feeding codes such as 92526 and 92610. Our speech therapy billing guide covers the full code set, modifiers, and common denials.
The first 60 days of 2027
Every coding transition produces a wave of denials in the first two months: claims with the old code, claims with units that don't match documentation, and payers whose systems aren't ready. Practices that come through cleanly do three things: they test claims with each major payer in the first week of January, they review every denial daily instead of monthly, and they hold claims for payers that haven't confirmed readiness rather than sending them into a black hole.
Sharp Networks Group handles speech therapy billing for practices that bill commercial insurance, Medi-Cal, and regional centers, inside the EHR they already use. If you'd like help preparing your codes, templates, and payer list for January, schedule a consultation.
Sources: ASHA, "Speech-Language Pathology Treatment Codes Replacing 92507," and ASHA coverage of the CY 2027 Medicare Physician Fee Schedule proposed rule. Payer adoption varies; confirm with each payer before billing.