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CPT code 96125 for standardized cognitive performance testing

CPT code 96125 is a billing code used by speech therapy providers for standardized cognitive performance testing, which includes a qualified healthcare professional’s assessment of a patient’s speech and language abilities. This assessment typically involves testing various aspects of speech, language, and cognitive-communication function using standardized tests, instruments, or software with established norms. The evaluation may focus on a patient’s understanding, expression, and pragmatic language skills.

A few examples of speech/language evaluations that could be billed using CPT code 96125:

  1. Assessment of a child with a suspected language delay: In this case, a speech-language pathologist might administer standardized tests such as the Preschool Language Scales-5 (PLS-5) or the Clinical Evaluation of Language Fundamentals-5 (CELF-5) to evaluate the child’s receptive and expressive language skills. They may also assess the child’s ability to understand and follow directions, and their use of appropriate grammar and syntax in spoken language.
  2. Evaluation of an adult with aphasia: Following a stroke or other brain injury, a person may develop aphasia, affecting their ability to understand and/or produce language. A speech-language pathologist might administer the Western Aphasia Battery-Revised (WAB-R) or the Boston Diagnostic Aphasia Examination (BDAE) to determine the severity of the aphasia and the specific language domains affected, such as naming, repetition, comprehension, and reading and writing.
  3. Assessment of a patient with cognitive-communication difficulties due to dementia: A speech-language pathologist may assess an individual with dementia to determine the extent of their cognitive-communication impairments. The assessment could include the administration of the Cognitive Linguistic Quick Test (CLQT) or the Ross Information Processing Assessment-2 (RIPA-2), which evaluates various cognitive domains such as attention, memory, executive function, and problem-solving, and their impact on communication.