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