This article breaks down how visit length under the proposed 2027 SLP coding changes affects what a session actually bills, walking through the 16-minute and 38-minute thresholds and how they play out for single-goal, multi-goal, and pediatric visits. It includes CMS's proposed payment figures by treatment category so practices can gauge the financial impact of scheduling changes ahead of the November 2026 final rule.
Published: 9/21/26 | Last updated: 9/21/26
This article walks through a proposed CMS rule and is meant as general planning information, not clinical or billing advice. Coding decisions for your practice should involve your billing team, your compliance advisor, and the official CMS record.
The public comment period on this rule closed September 14, 2026, and CMS is expected to issue a final rule around November 1, 2026. Every figure and threshold below is proposed, not final, and may change before then. You can follow the rule directly at CMS's CY 2027 Physician Fee Schedule proposed rule page or through the American Speech-Language-Hearing Association (ASHA).
Many clinics build their schedules around 30-minute visits. Under CPT code 92507, that worked fine, since 92507 is untimed: 1 unit, 1 flat rate, regardless of whether the visit ran 20 minutes or 45.
Starting January 1, 2027, 92507 will be deleted. In its place, 10 new codes bill based on how many minutes were spent on each disorder area, in 15-minute increments. A schedule built around a flat 30-minute block doesn't automatically carry over. This article focuses on a narrower question: How visit length itself affects what a session bills, and what that means for scheduling.
The new codes work in pairs: A base code for the first 30 minutes of a disorder area, and an add-on code for each additional 15 minutes. And 2 thresholds determine what actually bills.
To bill 1 unit of a base code, a clinician needs at least 16 minutes on that disorder area under the proposed midpoint rule. Anywhere from 16 to 37 minutes bills the same single unit. To also bill the 15-minute add-on code, total time on that disorder area needs to reach 38 minutes.
That gap between 30 and 38 minutes matters most for clinics that schedule 30-minute visits: At 30 minutes, a visit clears the base code cleanly, but it's 8 minutes short of ever reaching the add-on.
Under CMS's proposed 2027 conversion factor, a single-focus visit that stops at 30 minutes is projected to bill noticeably less than 92507 pays today. Reductions run roughly 15% to 35%, depending on the disorder area. Crossing into the 38-minute add-on range closes most of that gap. For a couple of categories, including speech sound production and the combined speech-and-language code, proposed rates at 38-plus minutes would exceed what 92507 pays today.
The pattern holds across categories: Stopping at 30 minutes tends to leave money on the table relative to 92507, and reaching 38 minutes recovers most or all of it. For a clinic scheduling strictly 30-minute visits, this is the central planning question: Keep the 30-minute block and expect lower per-visit payment on average, or build in the extra several minutes needed to reach 38.
Many visits today split a 30-minute block across 2 goals. For example, 15 minutes of articulation work and 15 minutes of voice work. Under the proposed codes, that pattern runs into the 16-minute threshold from both directions at once: 15 minutes doesn't clear the minimum for either disorder area on its own, so neither may be billable.
There's a built-in exception. If a visit is genuinely combined speech sound production and language work, the combo code family exists for that specific pairing and covers a full 30-minute block. That exception only covers that specific combination. A visit split between, say, fluency and voice work has no combo code to fall back on, and 2 15-minute halves risk becoming non-billable time for one or both goals.
The practical takeaway for billing: Any visit addressing more than one disorder area needs each area to individually reach 16 minutes, or needs to be restructured around the speech-and-language combo code specifically.
A note before this section: These are scheduling and coding illustrations, not a suggestion to change what treatment a patient receives. The goals a patient works on should still be driven entirely by their plan of care. These examples are meant to help your team think through how visit length and goal sequencing affect what ends up billable, so the coding reflects the work already happening.
The pattern across these scenarios: If a goal isn't going to reach 16 minutes this visit, it's often better captured on a different day, with its own dedicated block, than folded into today's visit as a few minutes that won't end up billable.
If a clinic standardized on 40-minute visits, that length comfortably clears both the base and add-on thresholds for a single-goal visit, and it's long enough to split 2 goals so each clears its own 16-minute base threshold in the same visit. Where it falls short is 3 simultaneous goals: 3 disorder areas each need at least 16 minutes, or 48 minutes total, more than a 40-minute slot allows.
When articulation and language goals can be worked into the same activity, for example targeting a sound within the same utterances used to build sentence structure, the full 30 minutes can be delivered as combined treatment through the speech-and-language combo code rather than split into 2 pieces. It's the only pairing with a dedicated combo code, and it pays more than a single base code alone. It only applies to that specific combination, and only when the treatment is genuinely integrated, not 2 goals addressed back to back in the same block.
Swallowing and feeding treatment isn't touched by this restructuring. CPT 92526, treatment of swallowing dysfunction and/or oral function for feeding, stays exactly as it is today: 1 flat, untimed unit per visit, with no minute threshold to clear.
What does change is the math when 92526 is billed on the same day as one of the 10 new codes. There's no bar between 92526 and the new speech-and-language family, the same as 92526 and 92507 are billable together today. The catch is MPPR: Pairing a 30-minute base code with 92526 on the same date of service triggers a payment reduction on 1 of the 2 codes, the same as pairing 2 base codes does. Pairing a base code with its own matching add-on code doesn't trigger this reduction; pairing it with 92526 does.
For example, a 30-minute visit where 20 minutes goes to speech sound production and the rest addresses a feeding goal would likely bill 1 unit of the speech sound production base code plus 1 unit of 92526, with MPPR trimming the combined payment slightly. Both goals still get addressed and billed in the same visit. As with any multi-code visit, documentation needs to clearly separate the time and clinical content for each billed code, even when both are billed on the same date of service.
CMS has proposed a separate, untimed code, currently labeled GSLPP, for patients up to age 21. It's a CMS-originated proposal, not a code that went through the standard American Medical Association (AMA)/ASHA CPT process, and it would work much like 92507 does today: 1 flat rate per day, regardless of session length.
If a payer adopts GSLPP for pediatric patients, a clinic's existing 30-minute scheduling habits may need little to no adjustment for that portion of the caseload. These 2 things are worth keeping in mind before leaning on this as a plan: First, GSLPP still needs to survive the final rule in November; whether it's finalized at all is genuinely undecided. Second, even if CMS finalizes it, each payer decides independently whether to adopt it. That includes state Medicaid programs and commercial insurers, who may choose GSLPP for pediatric patients or use the 10 new codes for everyone. That adoption picture may not be clear until close to January 1, 2027.
For patients over age 21, GSLPP never applies, and the scheduling questions above are what determine what a visit bills.
Pull a sample of recent visits and check actual treatment minutes per disorder area, not scheduled visit length. This shows how much of a caseload would land in the 30-minute base-only tier versus the 38-minute add-on tier under the proposed rules.
Decide, category by category, whether a small schedule extension makes sense. The gap between a 30-minute and a 38-to-40-minute slot is often the difference between a payment cut and a rate that matches or beats 92507.
Flag any visit that currently blends goals in 1 block, whether that's 2 15-minute halves, 3-way splits, or sessions where regulation and transition time eats into actual treatment minutes. These need either a longer visit with 16-plus minutes per goal, a look at whether the combo code applies, or a change in which goal leads the session.
Identify caseloads where a patient's attention or endurance, not the schedule, is the limiting factor. For these, a longer appointment slot won't help on its own; the plan needs to focus on getting 16 consecutive or aggregated minutes on 1 priority goal per visit.
Watch for GSLPP's fate and payer adoption, since it changes the calculus specifically for the pediatric portion of a caseload and won't be settled until closer to the January 1, 2027 effective date.
We're tracking the proposed rule through the November final rule, and building visit-length and multi-goal scheduling logic into Prompt's documentation tools as the thresholds and values are confirmed. The goal is for your team to spend time deciding how to structure care, not manually calculating whether a visit cleared a billing threshold.
If you want help thinking through what this means for your specific schedule template, reach out to the Prompt team.
The most reliable place is ASHA's own tracking page, since it's specifically built for this and gets updated as things move:
For the official regulatory record (heavier reading, but most trustworthy/authoritative):
Not yet. 92507 stays valid through December 31, 2026. This is planning information for the transition, not a change you need to make today.
16 minutes on that specific disorder area, based on the proposed midpoint rule. This isn't final until CMS issues its rule in November.
38 minutes total on that disorder area under the proposed thresholds.
Only if each goal individually reaches 16 minutes, or if the visit qualifies for the speech-and-language combo code. Using 2 15-minute halves for unrelated goals generally won't clear the threshold for either.
No, 92526 stays untimed and unchanged. Billing it alongside one of the new codes on the same day can trigger a Multiple Procedure Payment Reduction on one of the 2 codes, the same as pairing 2 base codes does today.
A separate, untimed, CMS-proposed code for pediatric patients up to age 21. It didn't go through the standard AMA/ASHA CPT process, and whether it survives the final rule, and which payers adopt it, is still undecided.
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