Coding and coverage are important components of the reimbursement equation. Compliance information is a guide to help audiologists uphold professional standards. Find resources for coding, coverage, reimbursement, and compliance below. 

Coding

Find the latest updates in audiology coding and resources such as billing templates, guidance on modifier usage, and more here.

Reimbursement Coding

2020 and 2021 Coding Articles

To help address coding questions, the Coding and Reimbursement Committee has compiled articles that have appeared in Audiology Today.

New Audiology CPT Codes for 2021

There are seven new CPT codes for auditory-evoked potential (AEP) and vestibular-evoked myogenic potential (VEMP) services.

Coverage

Find the latest updates in Medicare coverage policies for audiology services.

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Participating in Medicare

Find a list of resources diving into how to participate in Medicare from sample claim forms to an advanced beneficiary notice (ABN) reference guide.

Medicare Frequently Asked Questions

Find a list of frequently asked questions regarding Medicare from advanced beneficiary notice to sending referral pads to physicians.

Reimbursement

Find the latest information regarding the Quality Payment Program and Merit-Based Incentive Payment System along with Medicare fee schedules for audiology services.

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Reimbursement News

The Academy has developed a list of new items for reimbursement for audiologists. Keep up with the latest reimbursement and coding news here.

Quality Payment Program and Merit-Based Incentive Payment System

As patients, payers, and policy-makers focus on quality care, the Academy will present up-to-date information on program participation.

Ask Your Audiology Organizations: Coding and Reimbursement Guidance from Your National Organizations

Members of the Academy's Coding and Reimbursement Committee (CRC) and the Practice Policy Advisory Council (PPAC) collaborated with other audiology organizations to develop coding guidance based on frequently asked questions (FAQs).

 

2023 Proposed Rule – Medicare Physician Fee Schedule

On July 7, 2022, the Centers for Medicare and Medicaid Services (CMS) issued the Proposed Rule on the 2023 Medicare Physician Fee Schedule Rule (MPFS). The rule is open for comment, and the final rule will be released in late fall 2022.

Medicaid

The Academy offers in-depth information on Medicaid. Continue to check back for more updates on Medicaid resources. 

State Medicaid (WIN12_ET/shutterstock.com)

State Medicaid

The American Academy of Audiology (the Academy) Coding and Reimbursement Committee (CRC) compiled an in-depth chart of State Medicaid contact information. The CRC hopes this chart will be a useful reference tool to provide an initial contact number for audiologists, contact information for State Medicaid program trainers, as well as links to State Medicaid program fee schedules and provider manuals.

Compliance

The Academy offers a wealth of resources to ensure audiologists and audiology practices maintain compliance with applicable federal regulations and more.

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Federal Regulations Affecting the Practice of Audiology

This summary guide includes information on the Anti-Kickback Statute. Safe Harbor, Stark laws, and the False Claims Act (FCA).

Food and Drug Administration (FDA) Hearing Aid Dispensing Guidelines

These guidelines involve the required use of a medical clearance, medical waiver, and other provisions for dispensing.

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COVID-19 Updates

COVID-19 updates are ongoing. The Academy is dedicated to providing its community with relevant and timely information. Keep a lookout for COVID-19 resources that will benefit you in any practice setting.