MedicaidBilling CodesMedium impact
BT2024127: Billing clarified for communication disorder evaluations by speech-language pathologists
Indiana Medicaid (IHCP)·IN · Physical Therapy, PM&R (Physical Medicine & Rehab)·Claims & Billing
Effective date
Aug 13, 2024
We identified it
Jun 19, 2026
Summary
Indiana Medicaid clarifies that speech-language pathologists can now bill specific CPT codes (92521-92523, 92597, 92607-92609) for communication disorder evaluations and speech-generating device services. Initial evaluations don't require prior authorization, but reevaluations need PA except within 30 days of hospital discharge with speech pathology orders.
Action Required
Immediately: Billing team must update system to allow speech-language pathologists to bill CPT codes 92521, 92522, 92523, 92597, 92607, 92608, and 92609 for Indiana Medicaid patients. Configure prior authorization requirements for codes 92597, 92607, 92608, and 92609, but allow initial evaluations and reevaluations within 30 days post-discharge without PA. Update encounter forms and notify speech-language pathologists of billable codes and PA requirements.