Speech Therapy Billing Is Changing in 2027: What Our Clients Should Know

If you receive speech, language, cognitive, or voice therapy, you may notice some changes to the way your therapy sessions are billed beginning January 1, 2027.

We know insurance and medical billing can be confusing, so we want to explain this change ahead of time—and, most importantly, what it may mean for you.

What is changing?

Currently, speech-language pathologists commonly use a billing code called CPT 92507 for individual treatment of speech, language, communication, and voice disorders.

One unusual feature of 92507 is that it is an untimed code. In simple terms, the same basic treatment code is used whether an appropriate therapy session lasts 30 minutes, 45 minutes, or another length of time.

Beginning January 1, 2027, CPT 92507 will be discontinued and replaced with a new group of more specific treatment codes.

The new codes will distinguish between different types of speech-language pathology treatment, including:

• Speech sound treatment

• Language treatment

• Combined speech and language treatment

• Fluency treatment

• Voice, resonance, and upper airway treatment

Another important difference is that these new codes will be based on treatment time. The new structure includes a code for the initial 30 minutes of direct treatment and an additional code that may be used for each additional 15 minutes of treatment.

Why does this matter for my therapy sessions?

For many clients, very little about therapy itself will change.

At Blue Ridge Speech and Voice, most of our treatment appointments are approximately 45 minutes, and we expect that to remain our typical session length. Your clinician will continue to make decisions about treatment length based on what is clinically appropriate for you.

The difference is that beginning in 2027, the amount billed to insurance may more closely reflect the type of therapy you receive and the amount of direct treatment time provided.

That means a 30-minute session and a 45-minute session may no longer result in the same amount being billed to your insurance company.

Can my session sometimes be longer?

Yes, when clinically appropriate and when scheduling allows.

Sometimes you and your clinician may be making particularly good progress on an activity and both have the availability to continue beyond the originally anticipated treatment time. In other situations, a longer appointment may be planned ahead of time because it makes sense for your treatment.

Under the new coding system, additional treatment time may result in an additional timed treatment code being billed.

We will not extend appointments simply for billing purposes. Session length will continue to be based on your clinical needs, progress during the session, clinician judgment, and scheduling availability.

Could this change what I pay?

Possibly—but it depends on your insurance plan. If your insurance plan gives you a flat copay, such as $25 or $40 per therapy visit, your cost may remain the same regardless of the amount your insurance company pays for the visit. However, you may notice more variation if your plan has coinsurance or if you are currently meeting your deductible.

If you have coinsurance

Coinsurance means that you pay a percentage of your insurance company's allowed amount rather than a fixed dollar amount.

For example, if your plan requires you to pay 20% of the allowed amount, your responsibility can change when the amount billed and allowed for a service changes.

Because the new speech therapy codes are based partly on treatment time, a 30-minute treatment session and a 45-minute treatment session could result in different allowed amounts—and therefore slightly different patient responsibilities.

If you are meeting a deductible

You may see a similar difference if you have not yet met your annual deductible.

When services are being applied toward your deductible, you are often responsible for your insurance company's contracted or allowed amount. Because the new codes distinguish between the initial treatment time and additional treatment time, your responsibility may vary depending on the services provided during that particular visit.

In other words, beginning in 2027, your speech therapy bill may not necessarily be exactly the same after every appointment, even when you are seeing the same clinician.

Does this affect swallowing therapy?

The primary change discussed here applies to treatment that is currently billed using CPT code 92507, including many speech, language, cognitive-communication, and voice therapy services.

Swallowing therapy uses a different treatment code and is not being replaced by this new code family.

If you receive both swallowing therapy and speech or voice therapy, however, your visit may include both types of services, and your billing may therefore be affected by the new speech-language treatment codes.

Is this just a Medicare change?

The new CPT codes themselves are not limited to Medicare. CPT codes are the standardized medical billing codes used by health care providers and insurers throughout the United States.

Medicare has proposed its payment amounts and policies for these new codes as part of the 2027 Medicare Physician Fee Schedule. Commercial insurance companies will establish their own coverage, contracted rates, and payment policies for the new codes.

Because each insurance company—and sometimes each individual insurance plan—can process services differently, we will not know every client's exact 2027 cost until insurers publish and implement their policies and fee schedules.

Is everything final yet?

Not quite.

The new CPT coding structure is scheduled to take effect January 1, 2027, and the current 92507 code will remain in use through December 31, 2026.

Medicare's proposed payment rates and related policies are not yet final. The Centers for Medicare & Medicaid Services (CMS) is expected to publish its final 2027 Medicare Physician Fee Schedule rule later this fall.

Commercial insurers will also need to establish their own policies and contracted rates for the new codes.

As more information becomes available, Blue Ridge Speech and Voice will review the changes and update our clients about anything that may affect their care or estimated out-of-pocket costs.

What do I need to do right now?

Nothing.

If you're currently receiving therapy, your sessions and billing will continue as usual through the remainder of 2026. We are sharing this information early because we believe clients deserve to understand changes that could affect their health care costs. As we get closer to January 2027 and insurance companies release their new fee schedules and policies, our team will work to provide updated cost estimates whenever possible.

Most importantly, our approach to treatment isn't changing: your clinician will continue to recommend the session length and treatment approach that best supports your individual goals.

Please remember that insurance benefit information and cost estimates are not guarantees of payment. Your insurance company ultimately determines how a claim is processed and what portion of the cost is assigned to you.