MSB was recently made aware that a notice was sent to NH Medicaid to School Providers indicating that some retroactive changes have been made to speech evaluation and consult codes.
The changes involve the expiration of the speech evaluation/consult procedure code 92506 – Evaluation of speech, language, voice communication and /or auditory processing (use for evaluation and re-evaluation). This change is effective December 31, 2013, which means this code can no longer be used by speech providers for evaluation/consult dates of January 1, 2014 and later.
The changes also involve the addition of four new, more specific speech evaluation procedure codes effective 1/1/2014. These codes must be used for speech evaluations dated January 1, 2014 and later. MSB has created new Speech Transaction Logs to reflect these changes. Per the notice, the new consult code will be provided in the near future, and at that time, we will update our transaction logs.
|Procedure Code||Modifier 1||Description||Rate||Notes|
|92521||TM||Evaluation of speech fluency||$114.27|
|92522||TM||Evaluation of speech sound production (e.g., articulation, phonological process, apraxia. dysarthia)||$92.78|
|*code 92522 & 92523
are restricted from the combination of same day billing; select the most appropriate code to bill either 92522 or
92523 but not both
|92523||TM||Evaluation of speech sound production (e.g., articulation, phonological process, apraxia. dysarthia); with evaluation of language comprehension and expression (e.g. receptive and expressive language)||$192.73|
|*code 92522 & 92523
are restricted from
the combination of
same day billing; select the most appropriate code to bill either 92522 or 92523 but not both
|92524||TM||Behavioral and qualitative analysis of voice and resonance||$96.72|
Your district has two options:
- MSB will return any logs dated January 1, 2014 forward that have speech evaluations documented on them. Your speech providers would select one of
the new codes and resubmit the logs to MSB for processing.
- MSB will retain the existing logs and not process the documented speech evaluations dated January 1, 2014 forward that do not reflect the new changes.
Please contact your Claims Analyst to inform them of which option you would like to choose by Monday, August 11. If we do not receive a response, we will retain the records we have on file and not process the evaluations.
In the event that claims were submitted and denied due to the use of the expired code, your Claims Analyst will contact you and advise as to how to proceed.
Please do not hesitate to contact your Claims Analyst with any questions.