92526 Oral function therapy
What 92526 is
CMS fee schedule short descriptor: Oral function therapy.
Full CPT long descriptions are licensed by the American Medical Association and are not published on this site; the short descriptor above is the one CMS prints in its own fee schedule file. See About CPT.
Medicare payment for 92526 (CY2026)
| Work RVU | Practice expense RVU | Malpractice RVU | Total | Medicare rate | |
|---|---|---|---|---|---|
| Non-facility (office) | 1.34 | 1.17 | 0.01 | 2.52 | $84.17 |
| Facility (hospital, ASC) | 1.34 | 1.17 | 0.01 | 2.52 | $84.17 |
National rates: total RVUs x the CY2026 conversion factor of 33.4009 (non-QP), before geographic adjustment. Actual Medicare payment is 80% of the rate shown after the deductible; the patient or secondary payer owes the 20% coinsurance.
Status: Active - payable under the Physician Fee Schedule. Global period: Global concept does not apply.
Medically Unlikely Edit (MUE)
Medicare caps 92526 at 1 unit per date of service for practitioner claims (MAI 2 - date of service edit (absolute): units above the MUE never pay), rationale: Anatomic Consideration. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.
Billed with 92526? These codes are bundled into it
92526 is a Column 1 code in 19 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.
| Column 2 code | Short description | Modifier indicator | |
|---|---|---|---|
36591 | Draw blood off venous device | 0 - no modifier bypass | Check pair |
36592 | Collect blood from picc | 0 - no modifier bypass | Check pair |
69705 | Nps surg dilat eust tube uni | 1 - modifier may bypass | Check pair |
69706 | Nps surg dilat eust tube bi | 1 - modifier may bypass | Check pair |
92511 | Nasopharyngoscopy | 1 - modifier may bypass | Check pair |
92520 | Laryngeal function studies | 1 - modifier may bypass | Check pair |
96523 | Irrig drug delivery device | 0 - no modifier bypass | Check pair |
97032 | Appl modality 1+estim ea 15 | 0 - no modifier bypass | Check pair |
97110 | Therapeutic exercises | 1 - modifier may bypass | Check pair |
97112 | Neuromuscular reeducation | 1 - modifier may bypass | Check pair |
97150 | Group therapeutic procedures | 1 - modifier may bypass | Check pair |
97530 | Therapeutic activities | 1 - modifier may bypass | Check pair |
97802 | Medical nutrition indiv in | 0 - no modifier bypass | Check pair |
97803 | Med nutrition indiv subseq | 0 - no modifier bypass | Check pair |
97804 | Medical nutrition group | 0 - no modifier bypass | Check pair |
99211 | Off/op est may x req phy/qhp | 1 - modifier may bypass | Check pair |
G0270 | Mnt subs tx for change dx | 0 - no modifier bypass | Check pair |
G0271 | Group mnt 2 or more 30 mins | 0 - no modifier bypass | Check pair |
G0283 | Elec stim other than wound | 0 - no modifier bypass | Check pair |
92526 is bundled into these codes
92526 appears as a Column 2 code in 2 active edits. Reported with one of these Column 1 codes on the same date of service, 92526 is the code that denies.
| Column 1 code | Short description | Modifier indicator | |
|---|---|---|---|
G0153 | Hhcp-svs of s/l path,ea 15mn | 1 | Check pair |
G0161 | Hhc slp ea 15 min | 1 | Check pair |
Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.