CPT 92523
Global XXX ActiveSpeech sound lang comprehen
CPT 92523 Billing & Documentation Guide
CPT code 92523 (Speech sound lang comprehen) is classified under Audiology with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 3.84, a non-facility practice expense RVU of 2.93, and a malpractice RVU of 0.01, a total non-facility RVU of 6.78 and facility RVU of 6.78. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $233.3, though rates vary from $212.5 to $296.8 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 92523, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 92523 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
No global period (E/M and other non-procedural services)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 92523 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 92523
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 3.84 | 3.84 |
| Practice Expense RVU | 2.93 | 2.93 |
| Malpractice RVU | 0.01 | 0.01 |
| Total RVU | 6.78 | 6.78 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 92523
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $248.84 | $248.84 | $237.88 - $283.67 | 29 |
| Florida | $227.1 | $227.1 | $222.32 - $230.98 | 3 |
| Georgia | $222.21 | $222.21 | $215.95 - $228.48 | 2 |
| Illinois | $223.91 | $223.91 | $218.13 - $230.26 | 4 |
| Michigan | $220.63 | $220.63 | $217.99 - $223.26 | 2 |
| North Carolina | $219.78 | $219.78 | $219.78 - $219.78 | 1 |
| New York | $243.97 | $243.97 | $221.47 - $253.45 | 5 |
| Ohio | $217.95 | $217.95 | $217.95 - $217.95 | 1 |
| Pennsylvania | $225.63 | $225.63 | $218.41 - $232.84 | 2 |
| Texas | $225.62 | $225.62 | $217.63 - $232.35 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 92523
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 92523 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0359T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0360T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0361T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0362T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0362T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0363T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 36591 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 36591 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 36592 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 36592 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
Frequently Asked Questions, CPT 92523
What does CPT code 92523 mean? +
CPT code 92523 represents: Speech sound lang comprehen. It's in the Audiology category with a global period of XXX.
What is the Medicare reimbursement for CPT 92523? +
The 2026 Medicare national average non-facility payment for CPT 92523 is $233.3. Rates range from $212.5 to $296.8 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 92523? +
Medicine section spans a wide range: therapy services use GP/GO/GN (PT/OT/SLP plans of care) and KX (above cap with documentation). Drug administration uses JW (waste) and JZ (no waste). Professional/technical split applies to some diagnostic codes.
What bundling edits apply to CPT 92523? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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