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CO HCPF Speech Therapy Billing Manual — Coding Tables

CodingTables

activein force · 2026-07-26 – presentas-observed

Thefollowingplaceofservicecodesareallowed:

PlaceofService(POS)

CodeDescription

02

Telemedicine-notprovidedinpatient’shome.RefertotheTelemedicineBillingManual.

03

School-(non-public)servicesprovidedinorduringpublicschoolmustbebilledbytheschooldistrictonly

10

Telehealth-providedinpatient’shome.RefertotheTelemedicineBillingManual.

11

Office

12

Home

13

AssistedLivingFacility

99

Other-(CommunityBasedOrganization)

EffectiveMay3,2024,placeofservice03isanallowedplaceofserviceforallfee-for-servicebenefits.Inorderforcommunityproviderstobillfee-for-servicetochildreninaschoolsetting,theprovidermustfollowschooldistrictpolicy.PleasereferencetheCommunityProvidersinaSchoolSettingPolicymemo.

Telemedicineplaceofservice(POS)code02isavailableforspecificprocedurecodes.VisittheTelemedicine-ProviderInformationwebpageforalistofallowedprocedurecodes.

SpeechtherapyservicesprovidedatanOutpatientHospitalarereportedontheinstitutionalclaimtypeandarereimbursedaspartofthehospital'sEAPGpayment.InstitutionalclaimtypesdonothavethePOScodefield.

SpeechtherapyservicesprovidedataFederallyQualifiedHealthCenter(FQHC)arebilledaspartoftheencounterratefortheFQHC.Theyarenotbilledseparatelyonprofessionalclaims.

Ruleallowsforspeechtherapyservicestoberenderedatalocationof"CommunityBasedOrganization".SincethereisnoexactPOScodewhichalignswiththisdescription,POScode99shouldbereported.

NCCIMUEeditsstipulatemaximumdailyunitsforeachcode.VisittheNCCIwebpageforfurtherinformation.

ProvidersshouldreferenceofficialAMACPTresourcesforfulldescriptionsofcodesandinstructionforproperuse.

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EffectiveDecember1,2023,appropriatemodifiersrequiredonboththePARandclaimsubmission.Allclaimsmustincludethecorrectmodifier,regardlessofPARrequirements.

OutpatientTherapyType

Modifier1

Modifier2

RehabilitativeSpeechTherapy

GN

97

HabilitativeSpeechTherapy

GN

96

EarlyInterventionSpeechTherapy

GN

TL

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ProcedureCode

UnitLimitsMax#unitspermember,perprovider,perDOS

PriorAuthorizationRequired

Notes

92521

NCCIMUEvalue

No

92522

NCCIMUEvalue

No

92523

NCCIMUEvalue

No

92524

NCCIMUEvalue

No

92507

NCCIMUEValue(thisisanencounter-basedcodetobebilledatamaximumof1unitofserviceperday)

DoesnotrequireaPARforthefirst12sessions,requiresPARafter12sessionsareutilized.

92508

NCCIMUEValue(thisisanencounter-basedcodetobebilledatamaximumof1unitofserviceperday)

DoesnotrequireaPARforthefirst12sessions,requiresPARafter12sessionsareutilized.

92520

NCCIMUEValue

No

92526

NCCIMUEValue

DoesnotrequireaPARforthefirst12sessions,requiresPARafter12sessionsareutilized.

92597

NCCIMUEValue

No

92605

NCCIMUEValue

No

92606

NCCIMUEValue

No

92607

NCCIMUEValue

No

92608

NCCIMUEValue

No

92609

NCCIMUEValue

DoesnotrequireaPARforthefirst12sessions,requiresPARafter12sessionsareutilized.

92610

NCCIMUEValue

No

92611

NCCIMUEValue

No

92612

NCCIMUEValue

No

92614

NCCIMUEValue

No

92626

NCCIMUEValue

No

92627

NCCIMUEValue

No

96105

NCCIMUEValue

No

96111

NCCIMUEValue

No

96112

NCCIMUEValue

No

96113

NCCIMUEValue

No

G0515(Enddate12/31/2019)

NCCIMUEValue

No

97129

NCCIMUEValue

DoesnotrequireaPARforthefirst12sessions,requiresPARafter12sessionsareutilized.

97130

NCCIMUEValue

DoesnotrequireaPARforthefirst12sessions,requiresPARafter12sessionsareutilized.

97755

20perday,60perfiscalyear

Yes

Modifiers96or97arenotrequiredforthisprocedurecodeasthisevaluationcannotbeclassifiedaseither'rehabilitative'or'habilitative'.

Q3014

NCCIMUEValue

No

V5011

NCCIMUEValue

No

ForusewithColoradoHomeInterventionProgram

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Provenance

Source
hcpf.colorado.gov
Retrieved
2026-07-26
Edition
2026-07-26
Content hash
27ab9c03bd0cc61e4000465d23ddbec58ca7fb63b76b554a4051601d8a4fcaab
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