The Centers for Medicare & Medicaid Services (CMS) has released its proposed 2027 Medicare Physician Fee Schedule (MPFS), outlining significant coding, payment, and policy changes that could affect speech-language pathologists (SLPs) and audiologists beginning January 1, 2027. CMS is accepting public comments, from individuals and organizations, through September 14, 2026.
Why This Matters for TSHA Members
The proposed 2027 Medicare rule represents one of the most substantial coding changes for speech-language pathology in years. While the new CPT structure offers more precise reporting of treatment services, concerns remain about reimbursement reductions, MPPR application, and the proposed pediatric G-code. Texas SLPs and audiologists should closely monitor the rulemaking process and consider submitting comments to help shape final the Medicare policy.
Medicare policy can influence reimbursement far beyond the Medicare population. We will continue to watch these developments, as other payers, including Texas Medicaid adopt changes as CPT code 92507 is deleted on January 1, 2027.
Major Changes to Speech-Language Pathology Coding
One of the most significant updates is the retirement of CPT code 92507, which has long been used to report individual speech-language treatment services. CMS proposes replacing it with 10 new CPT codes that more specifically describe treatment based on clinical focus and time duration. The new code family covers:
Each category includes a base code for the first 30 minutes of treatment and an add-on code for each additional 15 minutes. CMS has largely accepted the valuation recommendations developed through the American Medical Association's CPT process.
View this resource from ASHA for an overview of Placeholder CPT codes, proposed RVUs and an estimated payment
View this resource from ASHA for more information about each of the new ten codes
New Pediatric SLP G-Code Proposed
CMS has also proposed creating a new Medicare-specific HCPCS code, GSLPP, for pediatric speech-language pathology services.
According to CMS, the code was developed because of concerns that the new CPT structure may not fully capture pediatric treatment.
There is still much to be learned about this new G code, but it appears that:
TSHA is reviewing the available information closely and looking to collect feedback from members, as we develop our comment to CMS. Although this proposal is only for Medicare, and there is a limited population that would bill pediatric services to Medicare, its payment and coding policies often become the benchmark for the broader healthcare system. Therefore, we are more broadly watching this, as Medicare policy can influence reimbursement far beyond the Medicare population. Specific concerns include:
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With the code being based on a 60-minute treatment and the RVU proposed, we believe there may be an undervaluation of complex pediatric treatment. CMS is seeking stakeholder feedback on the typical duration and intensity of pediatric speech-language pathology services, and that input could influence the final valuation of the proposed code.
Advocacy Note: ASHA has formally urged CMS to reject the proposed GSLPP code and instead rely on the new CPT code family, which they believe already includes pediatric services. As TSHA prepares our comment for CMS, we welcome input from members.
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Audiology Updates
The proposed 2027 MPFS rule also introduces four new vestibular diagnostic CPT codes, including codes for video head impulse testing (vHIT) and updated rotational vestibular assessment services. CMS accepted most recommended valuations but proposed a lower work value for one vestibular testing add-on code (an add-on code for VST when performed with SHA testing), which could reduce reimbursement for certain audiology services.
Advocacy Note: TSHA will urge CMS to adopt the RVS Update Committee (RUC) recommended work value of 0.48 instead of the proposed RVU of 0.35 for the add-on VST CPT code.
Other Areas of Note in the Proposed 2027 MPFS
Multiple Procedure Payment Reduction (MPPR)
CMS proposes classifying the new speech-language pathology treatment codes as “always therapy” services. As a result, the base codes would be subject to Medicare’s Multiple Procedure Payment Reduction (MPPR) policy when multiple therapy services are provided on the same day.
This policy reduces the practice expense portion of payment for certain services, potentially decreasing reimbursement for clinicians treating patients with multiple therapy needs. This is an important component of the overall billing process, which can reduce reimbursement for services for speech-language pathologists and audiologists, and may warrant additional comments.
Advocacy Note: ASHA has created a Take Action campaign regarding MPPR and posted information about how it is impacted in this proposed rule.
Medicare Payment Reductions Continue
Beyond coding changes, many clinicians are focused on the payment outlook, as overall reductions in reimbursement occur.
CMS proposes reducing the 2027 Medicare conversion factor by 1.68% for most clinicians who do not participate in a qualifying Alternative Payment Model (which includes most speech-language pathologists and audiologists). In addition, proposed changes to practice expense calculations could further reduce reimbursement for many services. ASHA estimates that overall Medicare payments to audiologists could decrease by approximately 3%, while SLPs should also expect payment reductions. Because CMS groups speech-language pathology with physical and occupational therapy in its payment impact analysis, the specific effects of the proposed payment changes on speech-language pathology services are not separately identified.
Advocacy Note: CMS should provide a separate speech-language pathology impact analysis because combining SLP services with physical and occupational therapy masks specialty-specific effects, making it difficult for providers to accurately assess, plan for, and respond to proposed Medicare payment and policy changes.
Other Notable Policy Changes
Additional proposals that ASHA has flagged include:
To learn more about these issues, visit https://www.asha.org/news/2026/2027-medicare-part-b-proposed-rule-coding-payment-and-policy-analysis/?srsltid=AfmBOopsxN03AiN4LRSQPmk1oXYlVm4v99W44FR8YaSYpyba-Oag-Ivl.
What Happens Next?
CMS will accept public comments on the proposed rule through September 14, 2026, and is expected to publish a final rule in early November.
TSHA: TSHA is preparing a comment on the proposed rule, which is due September 14. We seek member feedback to ensure that we hear your thoughts as we prepare this comment. Please respond to our survey by August 31.
ASHA: ASHA has launched advocacy efforts encouraging audiologists and SLPs to provide feedback on key issues, including vestibular code valuation, telehealth coverage, MPPR policies, and the proposed pediatric G-code.
Resources: