OAR 410-129-0200
Speech-Language Pathology Procedure Codes

(1) Inclusion of a current procedural terminology (CPT) or healthcare common procedure coding system (HCPCS) code in sections (2), (3) and (4) does not mean a code is covered. Refer to OAR 410-141-0480, 410-141-0500, and 410-141-0520 for information on coverage.
(2) The following Speech therapy services are subject to PPR when paired above the funding line on the HERC prioritized list (see OAR 410-141-0520), when visits have not exceeded the allowed 30 habilitative and 30 rehabilitative visits allowed in a calendar year:
(a) 92507 Treatment of speech, language, voice, communication and auditory processing disorder, individual; and
(b) 92508 Group, two or more individuals.
(3) PA is required for SLP services:
(a) When there is documented need for extended service, considering 60 minutes as the maximum length of a treatment session;
(b) When there is documented need for continuing rehabilitative or habilitative therapy, considering 30 habilitative and 30 rehabilitative visits in a calendar year;
(c) When requesting services for treatments that are below the funded line or not otherwise excluded from coverage per OAR 410-141-0480;
(d) For the following services:
(A) E2500 Speech generating device, digitized speech, using prerecorded messages, less than or equal to eight minutes recording time;
(B) E2502 Speech generating device, digitized speech, using prerecorded messages, greater than eight minutes but less than 20 minutes;
(C) E2504 Speech generating device, digitized speech, using prerecorded messages, greater than 20 minutes but less than 40 minutes;
(D) E2506 Speech generating device, digitized speech, using prerecorded messages, greater than 40 minutes recording time;
(E) E2508 Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device;
(F) E2510 Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access;
(G) E2511 Speech generating software program for personal computer or personal digital assistance;
(H) E2512 Accessory for speech generating device, mounting system;
(I) E2599 Accessory for speech generating device, not otherwise classified;
(J) L7520 Repair prosthetic device, labor component, for 15 minutes;
(K) L8510 Voice amplifier; and
(L) V5336 Repair, modification of augmentative communication system or device excluding adaptive hearing aid.
(4) Services not subject to PPR or PA:
(a) 92521 Evaluation of speech fluency (e.g., stuttering, cluttering);
(b) 92522 Evaluation of speech sound production (e.g., articulation, phonological process, apraxia, dysarthria);
(c) 92523 Evaluation of speech sound production (e.g., articulation, phonological process, apraxia, dysarthria) with evaluation of language comprehension and expression (e.g., receptive and expressive language);
(d) 92524 Behavioral and qualitative analysis of voice and resonance;
(e) 92597 Evaluation for use and fitting of voice prosthetic device to supplement oral speech;
(f) 92607 Evaluation for prescription for speech-generating augmentative and alternative communication device, face-to-face with the patient, first hour;
(g) 92610 Evaluation of oral and pharyngeal swallowing function, limited to two per 12-month period;
(h) 92608 Each additional 30 minutes (List separately in addition to code for primary procedure);
(i) 92611 Motion fluoroscopic evaluation of swallowing function by cine or video recording, limited to two per 12-month period;
(j) S9152 Speech therapy, re-evaluation, limited to four per 12-month period;
(k) A4649 Supplies for speech therapy, limited to two per calendar year not to exceed $4.75 each;
(L) 92526 Treatment of swallowing dysfunction and oral function for feeding;
(m) 92609 Therapeutic services for the use of speech-generating device, including programming and modification;
(n) L7510 Repair of prosthetic device, repair or replace minor parts;
(o) L8500 Artificial larynx, any type;
(p) L8501 Tracheostomy speaking valve;
(q) L8507 Tracheoesophageal voice prosthesis, patient inserted, any type, each;
(r) L8509 Tracheoesophageal voice prosthesis, inserted by a licensed health provider, any type;
(s) L8515 Gelatin capsule, application device for use with tracheoesophageal voice prosthesis, each; and
(t) L9900 Orthotic and prosthetic supply necessary or service component of another HCPCS L code (PA required).

Source: Rule 410-129-0200 — Speech-Language Pathology Procedure Codes, https://secure.­sos.­state.­or.­us/oard/view.­action?ruleNumber=410-129-0200.

Last Updated

Jun. 8, 2021

Rule 410-129-0200’s source at or​.us