Longer Feeding Therapy Does Not Automatically Mean More Billing Units

The code determines how units work

A feeding treatment lasts an hour instead of half an hour. The clinician provided more care, but the billing team cannot assume the claim should contain twice as many units. The first question is whether the reported service uses a timed or untimed code.

ASHA identifies 92526, used for swallowing and oral function treatment for feeding, as an untimed service reported once per date of service regardless of the total treatment time. Applying a fifteen-minute unit calculation to that code changes the claim without changing its reporting rules. [1]

For an SLP practice, this distinction belongs in the scheduling and billing workflow. A template that multiplies units for every longer appointment can create errors even when the clinical care is appropriate.

Time still belongs in the record

Untimed does not mean undocumented. Describe the treatment, the patient’s response, and the clinical decisions that shaped the session. Record duration as appropriate to the documentation requirements that apply.

Consider an infant feeding appointment that requires repeated observation, a change in the treatment approach, and caregiver instruction. The note should explain those services. The length of the appointment alone does not establish additional 92526 units.

A second code needs a distinct service

A practice may provide more than one type of service during an encounter. Each reported service needs to match what actually occurred, with review of applicable coding edits and payer requirements.

Do not add a general therapy code simply to compensate for the length of feeding treatment. Ask what separate work the additional code represents and whether the record supports it. ASHA provides guidance for combining timed and untimed services; the team should consult that guidance rather than treating all appointment minutes as interchangeable. [1]

Fix the economics without changing the clinical story

If a payer’s rate does not support the time required for appropriate care, make that a contracting and practice-planning issue. Compare the allowed amount with clinician time, administrative work, and the cost of maintaining the service.

Train the billing team to recognize which codes are timed, which are untimed, and which questions need clinician review. Review software defaults before they affect an entire batch of claims.

Patients need enough time for the care they receive. Practices need reimbursement that supports that care. Accurate reporting gives a practice a sound basis for both conversations.

Source: [1] ASHA: Understanding Timed and Untimed CPT Codes

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