HCFA Clarification Issued

HCFA issued a clarification on April 30, 2001 to all Medicare carriers regarding 'Payment for Services Furnished by Audiologists' Medicare is required to pay for diagnostic tests 'performed by a qualified audiologist... this type of testing is paid for when a physician orders testing to obtain information as part of his/her diagnostic evaluation... The audiologist's diagnostic services should be covered, even if the only outcome is the prescription of a hearing aid.'

According to Dr. Barry Freeman of Nova Southeastern University, this clarification of policy requires Medicare carriers to pay for audiology services with a diagnosis of sensorineural hearing loss and if medical/surgical treatment is not required. Dr. Freeman also explained that HCFA will not pay without a physician referral or for routine retests when the diagnosis is already known. This is a major clarification for audiologists who currently are not billing Medicare for hearing care services.

This clarification would not have been possible without the cooperative efforts of audiologists from across the country who are members of the American Academy of Audiology and the Academy of Dispensing Audiologists. Special recognition and thanks go to Angela Loavenbruck, Craig Johnson, Jim McDonald, Bob Glaser, and David Fabry.