This guide aims to provide coding, billing, and coverage guidance for audiology services for auditory processing disorder.
Clinicians are strongly encouraged to reference payer-specific policies when determining appropriate code reporting and documentation requirements for testing. Further, Medicare local coverage determinations and other payer policies will address which ICD codes support medical necessity and subsequent reimbursement for services. It is advisable to review payer guidelines and policies prior to billing.
Testing for Auditory Processing Disorder (APD) refers to evaluation of the central, as opposed to the peripheral, auditory system. Several tests of central auditory function comprise an auditory processing test battery. These separate tests may include but are not limited to evaluation of different auditory processing functions, such as auditory temporal processing, auditory pattern processing, binaural separation, binaural integration and auditory performance with degraded acoustic signals.
Relevant Evaluation Codes
The following Level I HCPCS CPT codes are available for reporting assessment of central auditory processing function. The CPT codes used for an APD evaluation do not require specific tests; the evaluation (encompassed by CPT codes 92620 and 92621) is time-based, which allows the audiologist to choose the appropriate number of tests to complete the battery based upon individual patient needs.
| CPT Code | Description |
| 92620 | Evaluation of central auditory function, with report; initial 60 minutes |
| 92621 | Evaluation of central auditory function, with report; each additional 15 minutes *(CPT Manual Instructions: Code first 92620.) |
| 92571 | Filtered speech test Report 92571, 92572, or 92576 only if administering that test in isolation – if more than one test is administered, utilize 92620/92621. |
| 92572 | Staggered spondaic word test Report 92571, 92572, or 92576 only if administering that test in isolation – if more than one test is administered, utilize 92620/92621. |
| 92576 | Synthetic sentence identification test Report 92571, 92572, or 92576 only if administering that test in isolation – if more than one test is administered, utilize 92620/92621. |
| *Note: The CPT manual parentheticals presented here do not include Medicare’s National Correct Coding Initiative (NCCI) procedure to procedure edits. The full list of NCCI edits and other information related to same-day billing can be found here. | |
Do not report CPT code 92506 (Evaluation of speech, language, voice, communication, auditory processing, and/or aural rehabilitation status), as this is a code utilized by speech-language pathologists and NOT audiologists.
Relevant Rehabilitative Codes
The following list of codes are typically only reimbursable when provided by a licensed speech-language pathologist. Audiology providers are strongly encouraged to review payer-specific coverage policies prior to reporting the codes presented within this section.
| CPT Code | Description |
| 92507 | Treatment of speech, language, voice, communication, and/or auditory processing disorder; individual |
| 92508 | Treatment of speech, language, voice, communication, and/or auditory processing disorder; group, 2 or more individuals |
| Note: These services are typically non-covered when performed by audiologists. Reference payer-specific coverage policies to determine whether these services are non-covered and should subsequently be moved to self-pay. | |
Relevant Diagnosis Codes
The ICD code H93.25 Central auditory processing disorder is most appropriate for reporting a diagnosis of auditory processing disorder. A more complete list of ICD codes relevant to audiologic practice are available here.
Frequently Asked Questions
- Are there specific tests that are required to report codes 92620 and 92621?
- Are counseling and report writing included in the work of 92620 and 92621?
Need more help?
Contact us at reimbursement@audiology.org.
Resources
- Clinical Practice Guidelines: Diagnosis, Treatment, and Management of Children and Adults with Central Auditory Processing Disorder - American Academy of Audiology
- (C)APD Case Study Discussion - American Academy of Audiology
- Implementing a Protocol for Patients with Acquired Brain Injury in an Audiology Practice - American Academy of Audiology
CPT codes, descriptions, and other data are Copyright 1966, 1970, 1973, 1977, 1981, 1983–2024 American Medical Association. All rights reserved. CPT© is a registered trademark of the American Medical Association.
Disclaimer
The purpose of the information provided by the American Academy of Audiology Coding and Reimbursement Committee is strictly for educational guidance to audiologists. Action taken with respect to the information provided is an individual choice. The American Academy of Audiology hereby disclaims any responsibility for the consequences of any action(s) taken by any individual(s) as a result of using the information provided, and reader agrees not to take action against, or seek to hold, or hold liable, the American Academy of Audiology for the reader's use of the information provided. As used herein, the "American Academy of Audiology" shall be defined to include its directors, officers, employees, volunteers, members, and agents.
