Guidelines on Updated CPT Code for Speech Therapy

Speech therapy billing relies on accuracy, compliance, and up‑to‑date knowledge of coding requirements. For 2025, the core CPT codes for speech‑language pathology services remain unchanged, but there are important updates that every provider, billing specialist, and clinic manager should know—especially regarding new Medicare G‑codes for caregiver training. This guide breaks down the most relevant codes, modifiers, documentation tips, and payer considerations so you can bill correctly and optimize reimbursement.

Speech therapy billing is never static—regulatory updates, new procedural codes, and payer rules mean providers must constantly adapt. The 2025 CPT and HCPCS updates bring important changes, especially for Medicare-specific caregiver training, telehealth billing, and payment structures. If you’re managing speech billing codes, staying on top of these changes isn’t optional—it’s the foundation for clean claims, faster payments, and compliance.

What’s New and What Didn’t Change in 2025 CPT/HCPCS Updates

The American Medical Association (AMA) has confirmed that the fundamental CPT codes for speech therapy will remain the same in 2025. Providers can continue to bill using the same established codes for evaluations, treatments, and therapy interventions as in previous years.

What’s New: Medicare G‑Codes for Caregiver Training

Although CPT codes remain stable, Medicare has introduced new G‑codes for caregiver training provided without the patient present. These codes aren’t CPT codes, but they matter for SLPs treating Medicare patients or working with commercial payers who adopt similar standards.

• G0541 – Individual caregiver training without patient present

• G0542 – Group caregiver training (two to six caregivers) without patient present

• G0543 – Group caregiver training (seven or more caregivers) without patient present

Why this matters: If you’re training family members or caregivers to assist with speech therapy goals outside of direct sessions, these codes may allow for billable services. Always check payer-specific rules before billing.

Common CPT Codes for Speech Therapy

Knowing the most frequently used CPT codes is essential for accurate claims. Here’s a breakdown of the primary ones:

CPT Code	Description	Common Use Case
92507	One‑on‑one treatment for disorders affecting voice, speech, language, communication skills, or auditory processing abilities.	Standard one-on-one therapy
92508	Group treatment, two or more individuals	Group therapy sessions
92521	Evaluation of speech fluency	Stuttering/cluttering evaluations
92522	Evaluation of speech sound production	Articulation or phonology
92523	Speech sound and language comprehension/expression evaluation	Comprehensive assessments
92524	Behavioral & qualitative analysis of voice and resonance	Voice and resonance analysis
92526	Treatment of swallowing dysfunction/oral function for feeding	Swallowing and feeding therapy
97129 / 97130	Cognitive function intervention (initial/each additional 15 minutes)	Cognitive-communication therapy

Other codes may apply for device evaluations (92605–92609), aphasia assessments (96105), and developmental screenings (96110, 96112).

Using Billing Modifiers Correctly

Modifiers help clarify the circumstances of service delivery, which is crucial for payer acceptance.

• GN – Indicates the service is part of a Medicare‑approved speech‑language pathology plan of care.

• KX – Used when therapy exceeds Medicare caps but is medically necessary. Requires documentation.

• 22 – Increased procedural services due to unusual complexity or effort.

• 52 – Reduced services when the full procedure wasn’t completed.

• 59- A separate procedural service for situations in which two operations are not typically reported together.

Tip: Overuse of modifiers—especially 59—can trigger audits. Only apply when justified and supported by records.

Telehealth Billing Rules: Extensions, Limits, and Transition

Once you understand the coding structure, the next question is where these services can be delivered. Telehealth remains a critical piece for many providers.

• CMS has extended provisional telehealth status for therapy CPT codes through March 31, 2025.

• Medicare will no longer cover PT, OT, and SLP for telephone-only codes (98966–98968) as of April 1st—unless Congress steps in.

• For 2025, interactive audio-only systems qualify, but pre-PHE geographic and provider restrictions will likely return after year-end.

Stat: Roughly 2.75 million Medicare fee-for-service beneficiaries used telehealth in Q1 2024—a clear indicator of its relevance in SLP care delivery.

Why it matters: Knowing the cutoff date and rules for telehealth billing ensures your practice doesn’t face sudden denials or cash flow disruptions.

Caregiver Training: New Procedural Codes and Consent Flexibility

For certain SLP services, the patient does not need to be present. The 2025 revisions increase the flexibility and accuracy of these services' charging.

• Caregiver training is still covered under CPT 97550 and 97552 under a plan of care.

• HCPCS G0541–G0543 can be billed without a therapy plan of care starting in 2025.

• For certain SLP services, the patient does not need to be present. The 2025 revisions increase the flexibility and accuracy of these services' charging.

Stat: From January 1, 2025, CPT 97550/97551 and HCPCS G0541/G0542 must be delivered face-to-face with the caregiver alone for the full time unit—e.g., a full 30 minutes for initial code billing.

Why it matters: Proper use of these codes allows practices to expand service reach while maintaining compliance—especially for patients whose progress depends heavily on caregiver engagement.

What Are the Best Documentation and Billing Practices for Speech Therapy in 2025?

In 2025, coding accuracy alone isn’t enough documentation process can make or break reimbursement. Every CPT code you submit should align with the details of the session. For example, distinguish between timed and untimed sessions, and note exactly when services like AAC device evaluations (92607–92609), swallowing assessments (92610–92612), cognitive rehab (97129/97130), or sensory interventions (97533) are provided.

Never assume Medicare rules automatically apply to all payers. Cross‑check each insurer’s policies to avoid costly mistakes. Regularly audit your denied claims to spot recurring issues such as incorrect diagnosis pairing, missing modifiers, or billing group therapy codes when a one‑on‑one service was delivered.

Medical necessity documentation remains critical. Since the Bipartisan Budget Act of 2018, Medicare no longer imposes a hard cap on therapy services, but any services above the annual threshold require the KX modifier plus detailed notes supporting medical necessity.

A consistent internal review process—combined with accurate CPT code mapping—helps reduce denials and secure payment the first time. In short, successful speech therapy billing in 2025 requires both coding precision and airtight documentation practices to keep revenue flowing. 

Common Billing Pitfalls to Avoid

• Using the wrong code for group therapy: CPT 92508 applies when two or more patients are treated at the same time, not when a caregiver is present.

• Failing to update payer rules: Some insurers require pre‑authorization for specific CPT codes every year.

• Ignoring modifier requirements: Missing modifiers can cause automatic denials for Medicare claims.

• Not documenting caregiver training: For G‑codes, you must note that the patient was not present.

FAQ

1. What is the service code for speech therapy?

CPT code 92507 is most commonly used for individual treatment. Depending on the service—like group therapy, evaluations, or swallowing therapy—codes such as 92508, 92521, or 92526 may apply.

2. What modifiers are essential for billing SLP services above therapy caps or during group sessions?

Apply KX when medically necessary services exceed Medicare’s set thresholds. For group therapy under a speech‑language pathology plan of care, pair GN with CPT code 92508.

3. How to bill for speech therapy?

Select the correct CPT code for the service, pair it with the matching ICD‑10 diagnosis, apply necessary modifiers, and ensure documentation fully supports the billed session.

Conclusion

The updated CPT code guidelines for speech therapy in 2025 don’t change the descriptors—but they do change the way you bill, particularly for caregiver training and telehealth. Understanding the speech billing codes, modifier rules, and payment structures will protect your revenue and keep your practice compliant.

If you want fewer denials, faster payments, and a streamlined process for speech therapy billing, start by reviewing your current coding, telehealth policies, and modifier usage. Need expert help? Contact us today and ensure your billing practices are 2025-ready.