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CPT Code 92507 Billing Update Effective July 1 2025

South Dakota Medicaid·SD · Speech Therapy·Claims & Billing
Effective date
Jul 1, 2025
We identified it
Jun 21, 2026
Days to comply

Summary

South Dakota Medicaid is changing CPT code 92507 from a 15-minute time-based billing to a per-session billing model effective July 1, 2025. Providers can only bill one unit per member per day regardless of session length, with the new reimbursement rate set at $67.00 per session.

Action Required

Action needed
Before July 1, 2025: Billing team must update billing software and systems to bill CPT 92507 as one unit per member per day instead of 15-minute increments. Change reimbursement rate to $67.00 per session for CPT 92507 and $21.95 for CPT 92508. Additional units billed for the same member on the same day will be denied. School district providers are exempt and should continue billing in 15-minute increments.

Affected Billing Codes

92507
92508