CPT 92607, 92608, and 92609: An SLP's Guide to AAC Billing

Quick answer: CPT 92607 is the first hour of an AAC evaluation, and it's timed — the first 60 minutes of face-to-face time (2026 Medicare rate: $122.58). CPT 92608 is a timed add-on for each additional 30 minutes of that same evaluation ($47.76 per unit), and it can't be billed without 92607. CPT 92609 is the therapy and device programming that come after the device is in hand. It's untimed, billed once per session ($102.60).

You just finished a long AAC evaluation, and now you're staring at three related CPT codes, a stack of time-stamped notes, and a payer who wants every detail in the record. CPT 92607 is the first hour of the augmentative and alternative communication evaluation, 92608 is each additional 30 minutes of that same evaluation, and 92609 is the therapeutic services and device programming that come after.

They're a related set, but they cover three different stages of work, and mixing them up is one of the most common reasons AAC claims get denied. This guide walks through each code, the documentation it actually requires, and the denial traps that show up most often, so the claim gets paid the first time. For the broader picture of CPT coding in speech-language pathology, see our speech therapy CPT codes guide.

The Three Codes at a Glance

Code	Description	Timed / Untimed	When to use	Documentation needed	Denial risk
92607	First hour of the AAC evaluation, face-to-face with the patient (2026 Medicare rate: $122.58³)	Timed — the first 60 minutes	You're still deciding whether a speech-generating device fits and which one	Face-to-face time, modalities and devices trialed, language and cognitive findings, clinical reasoning toward the recommendation	Billing it for ongoing therapy that belongs under 92609
92608	Each additional 30 minutes of that same evaluation, add-on to 92607 (2026 Medicare rate: $47.76 per unit³)	Timed — billed per 30-minute unit	The evaluation runs past the first hour; one unit per additional 30 minutes	Point-of-care time-stamps for every unit billed, on a claim that also includes 92607	Submitting it without 92607, or guessing minutes instead of logging them
92609	Therapeutic services and device programming after the device is in hand (2026 Medicare rate: $102.60³)	Untimed — billed per session	The device is prescribed and the work is ongoing AAC therapy	Programming changes by feature, AAC competencies targeted, measurable progress, link to a plan-of-care goal	Generic notes, or billing it for evaluation work that belongs under 92607

What CPT 92607 Covers: The First Hour of an AAC Evaluation

CPT 92607 is the "evaluation for prescription for speech-generating augmentative and alternative communication device, face-to-face with the patient, first hour."¹ It's time-based, and that face-to-face requirement matters: the hour is the actual time you spend with the patient, not time spent on setup, scoring, or report writing after the session.

A typical first hour pulls in a communication needs assessment, a look at the patient's current modality use, a quick screen of language and cognitive ability, modality trials with one or two candidate devices, and an initial read on device candidacy. If you're working in a university clinic or a private practice that runs a four-week loaner-device trial, this is where that trial gets set up.²

Your documentation should reflect the face-to-face time, the activities performed, and a clean clinical reasoning trail toward (or away from) a speech-generating device recommendation. The 2026 Medicare national rate for 92607 is $122.58.³

A quick example. A pediatric SLP is evaluating a six-year-old with cerebral palsy and severe speech impairment. The first hour covers needs assessment, two device trials, and an early call on which platform might fit. That hour is 92607.

CPT 92608: Billing Each Additional 30 Minutes

CPT 92608 is an add-on code for each additional 30 minutes of face-to-face AAC evaluation beyond the first hour.⁴ It can't stand on its own. It must be billed in conjunction with 92607 on the same claim, and when the evaluation spans multiple sessions, you use the last date of service.

It can also be billed in multiple units. One unit equals 30 additional minutes. Two units equals 60 additional minutes. So an AAC evaluation that runs two hours and 15 minutes of face-to-face time gets billed as 92607 once plus 92608 twice, for the 60 additional minutes that meet the 30-minute increments.

Real time tracking is non-negotiable here. Payers will request time-stamps on audit, and loose rounding is a fast way to lose a claim. The 2026 Medicare national rate is $47.76 per unit of 92608.³

The most common pitfalls? Guessing minutes instead of logging them at the point of care, and submitting 92608 on a claim that doesn't also include 92607. Either one will bounce.

CPT 92609: Therapeutic Services and Device Programming

CPT 92609 covers therapeutic services for the use of a speech-generating device, including programming and modification.⁵ This is the code for ongoing AAC therapy. Patient and caregiver training. Programming personalized vocabulary. Modifying device settings as the user's skills change.

It is not the code for the AAC evaluation. Mixing 92609 with the evaluation work you should be billing under 92607 or 92608 is one of the top denial reasons across AAC claims.⁶

The documentation bar on 92609 is higher than most SLPs expect. "AAC training provided" doesn't cut it. Payers, Medicare especially, want specific programming changes, the communication competencies you targeted in the session (the four AAC competencies are linguistic, operational, social, and strategic), measurable functional progress, and a clear link back to a specific goal in the plan of care.⁵

A note on 92609 and 92507. You can bill both on the same day, but only when the documentation shows two distinct and separate services per the National Correct Coding Initiative. If you're doing AAC programming and broader speech-language treatment in the same session, the note has to separate them clearly.

The 2026 Medicare national rate for 92609 is $102.60.³

Concrete example. A teen with autism is in weekly therapy on a high-tech AAC device. Each session, the SLP works on social-communication targets, adjusts the vocabulary set based on what the patient is asking for at school, and documents measurable progress on a specific plan-of-care goal. That session is 92609.

92607 vs 92609: Evaluation or Therapy?

This is the confusion that drives more AAC denials than any other. The two codes sit at opposite ends of the same patient journey, and the tell is simple: 92607 is about deciding on a device, 92609 is about using one.

Reach for 92607 (with 92608 as needed) when you're still figuring out whether a speech-generating device is the right call and which one fits. The work is assessment, modality trials, candidacy decisions, and the clinical reasoning that leads to a recommendation. There's no device prescribed yet, or you're in the loaner-trial window building the case for one. These are timed codes: you're logging face-to-face minutes.

Reach for 92609 once the device is in hand and the work shifts to therapy. You're programming personalized vocabulary, training the patient and caregivers, targeting the four AAC competencies, and modifying settings as skills grow. It's billed per session, not per minute, and it repeats week after week as ongoing treatment.

The mix-ups cut both ways. Billing 92609 for evaluation work that belongs under 92607 is the classic error, but the reverse happens too: an SLP keeps billing 92607 for what are really ongoing therapy sessions long after the device was delivered. If the device is prescribed and you're providing treatment, it's 92609. If you're still deciding, it's 92607. Let the stage of care pick the code, not habit.

Documentation That Actually Gets AAC Claims Paid

The single biggest cause of 92609 denials is generic notes. The fix is specificity, and the same principle applies to 92607 and 92608.

For 92607 and 92608, document the face-to-face time, the modalities and devices trialed, the patient's response to each, the language and cognitive findings, and the clinical reasoning behind the device recommendation. If you ran a loaner trial, the note should reflect what changed week to week.

For 92609, document the programming changes you made by feature, the vocabulary you added or modified, the AAC competencies you targeted in the session, the patient's measurable progress on each, and the link back to a specific goal in the plan of care.

A few mechanics that quietly tank otherwise valid claims:

ICD-10 pairing. Link a primary medical code (the underlying neurological or developmental diagnosis) with a secondary speech and language code to establish medical necessity.⁶
Modifiers. Use the GN modifier on every Medicare SLP claim. Use KX once the therapy threshold is crossed and continued services remain medically necessary. Use 95 (or GT, depending on the payer) for telepractice sessions.⁷
Prior authorization. Many commercial payers require it for both the evaluation and the device itself. Verify before the first session. Medicare also requires a formal SLP evaluation documenting current communication impairment, language and cognitive ability, and whether daily communication needs could be met through other natural modalities before an SGD is delivered.⁸

Side-by-side, a payable 92609 note reads like a clinical record. A denied 92609 note reads like a tweet.

Common Mistakes With AAC Treatment CPT Codes (and How to Avoid Them)

A few patterns show up over and over in denied AAC claims.

Billing 92609 for the evaluation, or billing 92607 for an ongoing therapy session. Different codes for different work, and payers don't forgive the mix-up.

Forgetting that 92608 has to be billed with 92607. It's an add-on. It never stands alone.

Skipping the modifier. The GN, the KX over the threshold, the 95 or GT for telepractice. Each one is small, and each one is the difference between paid and denied.

Loose time tracking. Guessing minutes is fine until an audit asks for the math.

Notes that don't tie the session to the plan of care, or that don't mention any of the four AAC competencies. A clean note answers the question, "Why was this medically necessary today?"

Billing 92609 alongside 92507 without showing two distinct services. The claim might go through, but it might also come back, and the rework time costs more than getting it right the first time.

Starting an evaluation before verifying prior authorization. By the time you find out the payer needed an auth, the visit is over.

If your clinic has more than one biller or trains students, a one-page AAC documentation checklist on the wall solves most of these. Time-stamps. Modalities trialed. Competencies targeted. ICD-10 pairing. Modifier set. Five lines, and you catch most denials before they happen. For a broader rundown of the patterns that sink SLP claims, see our piece on SLP billing mistakes.

Frequently Asked Questions

Is 92609 timed?

No. Unlike 92607 and 92608, which are built on face-to-face minutes, 92609 is not a time-based code. It's billed once per session (per date of service), not in 15- or 30-minute units, and it covers the full therapeutic and programming service you delivered that day whether the session ran 30 minutes or a full hour. That doesn't mean the clock is irrelevant to your note, though. Payers still expect a skilled, substantive session, so document the specific programming changes, the AAC competencies you targeted, and the measurable progress, even though you're not logging units the way you do for the evaluation codes.

Can you bill 92609 without the patient present?

In practice, no. The 92609 descriptor doesn't carry the explicit "face-to-face with the patient" language that 92607 does, which leads some clinicians to assume standalone programming time is separately billable. But payers generally treat 92609 as a treatment service delivered with the patient present: the programming and modification are meant to happen in the context of a therapy session, tied to the patient's response and a plan-of-care goal. Device programming you do on your own, without the patient there, is typically folded into the bundled service rather than billed as a separate 92609 encounter. When in doubt, check the specific payer's policy before you submit.

What's the difference between 92607 and 92608?

Both cover the AAC evaluation, and both are timed. 92607 is the first hour, face-to-face with the patient. 92608 is an add-on for each additional 30 minutes beyond that first hour, billed one unit per 30 minutes. So a two-hour, 15-minute evaluation is 92607 once plus 92608 twice, for the 60 additional minutes that meet the 30-minute increments. The 2026 Medicare rate is $122.58 for 92607 and $47.76 per unit of 92608.

Can 92608 be billed on its own?

No. 92608 is an add-on code, so it never stands alone. It has to be billed in conjunction with 92607 on the same claim, and when the evaluation spans multiple sessions, you use the last date of service. Submitting 92608 on a claim that doesn't also include 92607 is one of the fastest ways to bounce an AAC claim.

What's the difference between 92607 and 92609?

They sit at opposite ends of the same patient journey. 92607 is about deciding on a device: assessment, modality trials, candidacy, and the clinical reasoning toward a recommendation, billed by face-to-face time. 92609 is about using one: programming personalized vocabulary, training the patient and caregivers, and modifying settings as skills grow, billed per session after the device is in hand. If you're still deciding, it's 92607. If the device is prescribed and you're providing treatment, it's 92609.

How many units of 92608 can you bill?

As many 30-minute units as the evaluation actually runs past the first hour, since one unit of 92608 equals 30 additional minutes of face-to-face time. Two units equals 60 additional minutes, and so on. An AAC evaluation that runs two hours and 15 minutes of face-to-face time gets billed as 92607 once plus 92608 twice, for the 60 additional minutes that meet the 30-minute increments. Log the time-stamps at the point of care for every unit, because payers will ask for the math on audit and loose rounding loses claims.

What modifiers do AAC billing codes require?

Use the GN modifier on every Medicare SLP claim. Add KX once the therapy threshold is crossed and continued services remain medically necessary. For telepractice sessions, use 95 (or GT, depending on the payer). Each modifier is small and easy to skip, but a missing one is the difference between paid and denied.

Bill the Right Code, Document Like the Auditor's Reading

Here's the short version. CPT 92607 is the first hour of the AAC evaluation. CPT 92608 is each additional 30 minutes of that same evaluation. CPT 92609 is the therapy and programming that come after the device is in hand. Each one has its own documentation bar, and each one has its own denial traps.

Build the one-page checklist, link the right ICD-10 codes, attach the right modifiers, and write the note like the auditor is reading it, because eventually one of them will be.

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