On July 14, 2026, CMS released the proposed 2027 Medicare Physician Fee Schedule, and for speech-language pathologists it's more than routine paperwork.1 This is the document that will decide what the ten new codes replacing 92507 actually pay. If you've been following the coding change but haven't thought about the money side, this is where the money side starts.
Here's the honest part up front. The rule is proposed, not final. The exact values won't be locked in until the final rule lands in November 2026. So think of this post as a map: how the Medicare Physician Fee Schedule sets a code's value, what the 2027 proposed rule says for SLPs, what the timed-code switch could mean for reimbursement, and how to read the proposed rule yourself. If you want the full backstory on the coding change, CPT 92507 is being deleted in 2027 covers it.
How the Medicare Physician Fee Schedule Actually Sets Your Payment
Most SLPs bill every day without ever seeing the formula behind the payment. It's worth a minute, because once you know it, the news stops sounding like a foreign language.
Outpatient speech-language pathology services under Medicare Part B are paid according to the Medicare Physician Fee Schedule, and it all runs on one equation.6 Medicare pays for a service as the sum of three relative value units, each adjusted for where you practice, all multiplied by a conversion factor.2 In plain terms, the formula is [(work RVU x work GPCI) + (practice expense RVU x PE GPCI) + (malpractice RVU x MP GPCI)] x conversion factor.2
Break that into pieces you can picture. The work RVU reflects your effort, the time, skill, and clinical judgment a service takes. The practice expense RVU covers overhead like your space, staff, and materials. The malpractice RVU covers liability. The GPCI, or Geographic Practice Cost Index, nudges each piece up or down based on your region's costs. And the conversion factor is the dollars-per-RVU multiplier that turns the whole thing into an actual payment.
So when ASHA says CPT 92507 is valued at 1.30 work RVUs based on a typical 60-minute session, that number is doing real work.3 It has sat there, largely unchanged, for more than 15 years, which is part of why the code was flagged for review in the first place.3 Understand the formula and every headline about RVUs and conversion factors suddenly has a place to land.
What the 2027 Proposed Rule Says (and Doesn't Yet) for SLPs
Start with the number that touches everyone: the conversion factor. For 2027, CMS proposed $33.17 for clinicians in advanced alternative payment models and $32.84 for everyone else, the group that includes most SLPs.1 Both are lower than the 2026 figures of $33.5675 and $33.4009, mostly because the temporary 2.5% increase Congress approved for 2026 is set to expire.4 That's the source of the downward pressure you may have heard about for SLP reimbursement in 2027.
A second piece worth watching is the efficiency adjustment. CMS is keeping the policy that trims physician work intraservice time by 2.5% for services that aren't time-based, and it plans to recalculate that adjustment every three years.1 The new SLP treatment codes are time-based, so they sit in a different bucket than the untimed 92507 did. How that plays out for each code is exactly the kind of detail the final rule will settle.
The proposed rule also carries the familiar therapy guardrails. The KX modifier threshold, the per-beneficiary amount above which you attest that continued therapy is medically necessary, is proposed to rise to $2,540 for 2027.1 The targeted medical review threshold stays at $3,000.1
Now the part that requires patience. CMS has not published final, itemized RVUs for the ten new codes, and by law all RVU determinations are CMS's to make and won't be finalized until November 2026.3 Anyone quoting you a firm 2027 payment per code right now is guessing. Treat every value as proposed until the final rule confirms it.
From One Untimed Code to a Timed Family: What Valuation Could Mean
The valuation question gets more interesting when you remember what's actually changing. Today, 92507 is a single untimed value for a session that runs about an hour. Starting in 2027, each disorder area gets a base code for the initial 30 minutes and an add-on code for each additional 15 minutes.3,5
That changes the arithmetic. Instead of one flat value per session, your payment will reflect the units you bill, which depend on documented treatment time. A base-plus-add-on family is valued differently than a single untimed code, because the total depends on how many increments you legitimately report.
What could that mean for SLP reimbursement? It cuts both ways. A longer, well-documented session on one disorder area may capture more than a single flat unit ever did. A short session may capture less. The point is that time and documentation now drive the total in a way they simply didn't under 92507. For the confirmed structure and the minute thresholds behind those units, lean on the pillar and our current CPT 92507 billing guide while the code is still active. And remember, the specific dollar figures behind all of this are still pending.
The Comment Period and Timeline: How to Read the CMS Proposed Rule
Here's a distinction that saves a lot of confusion: proposed is not final. A proposed rule is CMS's draft. It's an invitation to react, not a bill you have to pay yet.
The 2027 timeline is short enough to keep on a sticky note:
- July 14, 2026: CMS releases the proposed 2027 Medicare Physician Fee Schedule.1
- September 14, 2026: The comment period closes.1
- November 2026: CMS releases the final rule and finalizes the values.3
- January 1, 2027: The new codes take effect.3
So how do you actually read the thing? You don't read all 1,000-plus pages. You search the document for the therapy and speech-language pathology sections, find the tables listing proposed RVUs and the conversion factor, and pay attention to the spots where CMS says it is specifically requesting comment. Those requests are where your voice matters most.
And you do have a voice. ASHA reviews the CMS proposed rule for speech therapy provisions and submits formal comments by the deadline, and individual SLPs and clinic owners can comment directly or add weight to ASHA's advocacy.3 If you supervise a fall-2026 cohort in a university clinic, this is a real teaching moment too. Those students will graduate straight into timed billing, and watching how a proposed rule becomes a final one is a lesson they'll use for the rest of their careers.
What Clinic Owners and SLPs Should Do Before the Numbers Are Final
You can't control the conversion factor. You can control how ready you are. Here's a sensible order to work through while the rule is still proposed.
Budget in ranges, not false precision. If you're a private-practice owner modeling 2027 revenue, plug in the proposed conversion factor and treat the per-code values as a band, not a fixed number, until November. A forecast built on a draft is fine as long as you label it a draft.
Keep billing 92507 correctly through the end of 2026. Nothing changes tomorrow. Report 92507 for individual treatment as you always have, and keep those claims clean, because sloppy habits now become expensive once timed codes and tighter scrutiny arrive together.
Start capturing treatment time today. Even though 92507 doesn't require it, begin recording how long you spend and, where it's relevant, on which disorder area. Timed billing depends on accurate time records, and making that second nature now means it won't feel new in January 2027.
Tighten your medical-necessity documentation. New valuations and timed codes tend to invite more attention, not less. Notes that clearly show a service was skilled, medically necessary, and appropriate for that patient hold up better when scrutiny rises.
Confirm your systems are ready. Review any payer contracts that name 92507 specifically, check that your EHR and clearinghouse will support the new codes on day one, and keep an eye on ASHA's rollout and the November final rule. For the mechanics of getting paid under Part B, our guides to Medicare billing for speech therapy and Medicare Part B in a university speech-language clinic are good companions.
The through-line here is simple. The one lever fully in your hands is documentation, and it's the same lever that protects you no matter which way the final values land.
The Rule Is Proposed, So Prepare With What You Control
Short version: the 2027 Medicare Physician Fee Schedule is the rulebook that will price the new SLP codes, the numbers you're seeing now are proposed rather than final, and the real values won't be set until November 2026. The conversion factor is trending down, the codes are shifting from untimed to timed, and the one thing you can act on today is the quality of your documentation. Read the proposed rule once and every future one gets easier.
Want documentation that's already built for timed billing? ClinicNote's time-stamped SOAP notes, customizable templates for each disorder area, and documentation-gap reporting help SLPs capture the detail these new codes will demand, without adding busywork to your day. Get a demo and see how it fits your clinic.
Sources
- https://www.cms.gov/newsroom/fact-sheets/calendar-year-cy-2027-medicare-physician-fee-schedule-proposed-rule
- https://www.ama-assn.org/practice-management/medicare-medicaid/medicare-physician-payment-schedule
- https://www.asha.org/news/2026/update-on-cpt-code-92507-valuation-review-underway/
- https://www.asha.org/news/2025/medicare-finalizes-2026-medicare-fee-schedule-modest-updates-but-continued-cuts/
- https://www.asha.org/practice/reimbursement/coding/new-speech-language-pathology-treatment-codes-replacing-92507/
- https://www.asha.org/practice/reimbursement/medicare/feeschedule/