CPT 70371Radiology

Speech evaluation complex

CPT 70371 is used for complex speech evaluation procedures performed under radiological guidance, typically involving real-time imaging to assess swallowing function and speech mechanics.

Showing rates for

National Average

Base Medicare rate

$108.36

This calculator gives a typical-case estimate using standard Medicare modifier rules. Actual payment depends on payer policies, documentation, code-specific CMS status indicators, and locality. Verify before billing.

RVU breakdown

Work RVU

0.84

PE RVU (NF)

2.47

MP RVU

0.04

Total RVU

3.35

Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High

NCCI bundling edits

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Billing tips

Verify that facility versus non-facility status is correctly identified; both rates for 70371 are identical at $108.36, but incorrect place of service coding can trigger audits
Impact: Prevents claim rejections and reduces audit risk
Bill global code (without modifiers) when both technical and professional components are provided by same entity
Impact: Ensures full $108.36 reimbursement rather than split component payments
Document complexity factors that distinguish this from simpler speech evaluations: multi-positional imaging, quantitative measurements, multiple consistencies tested, and detailed pharyngeal analysis
Impact: Prevents downcoding to lower-paying evaluation codes, protecting $108.36 payment
Ensure radiologist's interpretation report is separate and comprehensive, including all fluoroscopic findings and time documentation
Impact: Critical for medical necessity justification and audit defense of 0.84 work RVUs
Verify pre-authorization requirements with individual payers before scheduling; many require prior approval for complex speech evaluations
Impact: Prevents post-service denials and patient financial liability issues
Code diagnosis precisely using ICD-10 codes for dysphagia, neurological conditions, or structural abnormalities rather than vague symptoms
Impact: Increases first-pass claim acceptance rate and reduces medical necessity denials

Common denials

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Frequently asked questions

What is the Medicare reimbursement rate for CPT 70371 in 2025?

The 2025 Medicare national average reimbursement rate for CPT 70371 is $108.36 for both facility and non-facility settings. This is based on 3.35 total RVUs multiplied by the 2025 conversion factor of 32.3465.

What is the difference between CPT 70371 and a standard speech evaluation?

CPT 70371 is a complex speech evaluation that includes radiological imaging (typically videofluoroscopy), while standard speech evaluations are clinical assessments without imaging. The complex evaluation provides dynamic visualization of swallowing and speech mechanisms, justifying the higher reimbursement and RVU assignment.

Can CPT 70371 be billed with modifier 26 or TC?

Yes, CPT 70371 can be split into professional (modifier 26) and technical (modifier TC) components when different entities provide the interpretation versus the equipment and staff. However, when both components are provided by the same entity, bill the global code without modifiers to receive the full $108.36 reimbursement.

How many RVUs is CPT 70371 worth in 2025?

CPT 70371 has 3.35 total RVUs in 2025, consisting of 0.84 work RVUs, 2.47 practice expense RVUs, and 0.04 malpractice RVUs. The practice expense RVU is the same for both facility and non-facility settings.

What documentation is required to bill CPT 70371?

Required documentation includes medical necessity for complex imaging-based evaluation, fluoroscopic imaging with radiologist interpretation, assessment of multiple consistencies or positions, quantitative swallowing measurements, integrated findings from both radiology and speech-language pathology, and treatment recommendations based on results.

What are common denial reasons for CPT 70371?

Common denials include insufficient medical necessity justification, lack of documentation supporting complexity level, duplicate service issues when billed with other speech studies same day, missing supervision documentation for split billing, and frequency limitation violations for repeat evaluations within short timeframes.

Who can bill CPT 70371?

CPT 70371 can be billed by radiologists, speech-language pathologists working in conjunction with radiology, otolaryngologists, and rehabilitation medicine physicians. The procedure requires fluoroscopy equipment and must involve qualified radiologist supervision with certified radiologic technologist support.