SLP’s Do Have a Reevaluation Code

April 25, 2016
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Rick Gawenda
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Physical therapists bill CPT code 97002 for a reevaluation. Occupational therapists bill CPT code 97004 for a reevaluation. But what CPT code do speech-language pathologists (SLPs) use to bill for a reevaluation? The answer depends on who is the insurance carrier and what is their policy. And did you also know that SLPs do have a reevaluation code that some private insurance carriers list as payable in their speech-language pathology policies? In this article, I will explain how to bill for a reevaluation to Medicare and private insurance carriers, reveal the reevaluation code that SLPs have and list several insurance carriers that state they pay for this unknown reevaluation code.

Lets start with when is a reevaluation warranted to be performed by the speech-language pathologist (SLP). A re-evaluation is not a routine, recurring service but is focused on evaluation of progress toward current goals, making a professional judgment about continued care, modifying goals and/or treatment or terminating services. A formal re-evaluation is covered only if the documentation supports the need for further tests and measurements after the initial evaluation.

Indications for a re-evaluation include:

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