2022 Proposed Medicare Physician Fee Schedule - Initial Calculations of Proposed Payment Rates for Audiology Services

On July 13, 2021, CMS issued the Notice of Proposed Rule Making for the CY 2022 Medicare Physician Fee Schedule (MPFS). The Academy payment policy team has organized a chart of the proposed payment rates for audiology service (see “Current Resources”) based on initial calculations. Staff will continue analysis and post additional guidance.

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7.13.21	CY 2022 Proposed Medicare Physician Fee Schedule – Initial Calculations of Proposed Payment Rates for Audiology Services
CPT Code	Descriptor	MPFS Final 2021	MIPS Proposed 2022	Difference Final 2021 vs Proposed 2022
92537	Caloric vestibular test with recording, bilateral; bithermal (ie, one warm and one cool irrigation in each ear for a total of four irrigations)	$39.86	$39.29	($0.57)
TC		$10.37	$8.73	($1.64)
PC		$29.49	$30.56	$1.07
92538	Caloric vestibular test with recording, bilateral; monothermal (ie, one irrigation in each ear for a total of two irrigations)	$21.71	$21.49	($0.22)
TC		$6.80	$5.71	($1.09)
PC		$14.91	$15.78	$0.87
92540	Basic vestibular evaluation, includes spontaneous nystagmus test with eccentric gaze fixation nystagmus, with recording, positional nystagmus test, minimum of 4 positions, with recording, optokinetic nystagmus test, bidirectional foveal and peripheral stimulation, with recording, and oscillating tracking test, with recording	$105.33	$103.78	($1.55)
TC		$31.76	$27.88	($3.88)
PC		$73.57	$75.90	$2.33
92541	Spontaneous nystagmus test, including gaze and fixation nystagmus, with recording	$24.31	$24.52	$0.21
TC		$4.54	$4.03	($0.51)
PC		$19.77	$20.49	$0.72
92542	Positional nystagmus test, minimum of 4 positions, with recording	$28.20	$28.21	$0.01
TC		$4.54	$3.69	($0.85)
PC		$23.66	$24.52	$0.86
92544	Optokinetic nystagmus test, bidirectional, foveal or peripheral stimulation, with recording	$17.18	$17.46	$0.28
TC		$3.57	$3.36	($0.21)
PC		$13.61	$14.10	$0.49
92545	Oscillating tracking test, with recording	$16.21	$16.12	($0.09)
TC		$3.57	$3.02	($0.55)
PC		$12.64	$13.10	$0.46
92546	Sinusoidal vertical axis rotational testing	$117.32	$134.34	$17.02
TC		$103.06	$119..90	$16.84
PC		$14.26	$14.44	$0.18
92547	Use of vertical electrodes (List separately in addition to code for primary procedure)	$9.72	$9.40	($0.32)
92548	Computerized dynamic posturography sensory organization test (CDPSOT), 6 conditions (ie, eyes open, eyes closed, visual sway, platform sway, eyes closed platform sway, platform and visual sway), including interpretation and report	$47.97	$47.02	($0.95)
TC		$15.56	$13.77	($1.79)
PC		$32.41	$33.25	$0.84
92549	Computerized dynamic posturography sensory organization test (CDPSOT), 6 conditions (ie, eyes open, eyes closed, visual sway, platform sway, eyes closed platform sway, platform and visual sway), including interpretation and report with motor control test (MCT) and adaptation test (ADT)	$60.93	$61.79	$0.86
TC		$18.47	$18.47	$0.00
PC		$42.46	$43.32	$0.86
92550	Tympanometry and reflex threshold measurements	$21.39	$21.83	$0.44
92551	Pure tone hearing test air – non covered	$11.34	$13.10	$1.26
92552	Pure tone audiometry (threshold); air only	$31.76	$40.64	$8.88
92553	Pure tone audiometry (threshold); air and bone	$38.57	$50.04	$11.47
92555	Speech audiometry threshold;	$23.98	$30.56	$6.58
92650	Aep scr auditory potential – non covered	$27.55	$25.86	($1.69)
92651	Aep broadband with i&r	$85.56	$82.62	($2.94)
92652	Aep thrshld est mlt freq i&r	$119.39	$109.15	($10.24)
92653	Aep neurodiagnostic i&r	$83.29	$80.27	($3.02)
92517	Vemp test i&r cervical	$81.35	$78.59	($2.76)
92518	Vemp test i&r ocular	$75.51	$73.55	($1.96)
92519	Vemp tst i&r cervical&ocular	$126.72	$122.92	($3.80)
92556	Speech audiometry threshold; with speech recognition	$37.92	$49.03	$11.11
92557	Comprehensive audiometry threshold evaluation and speech recognition (92553 and 92556 combined)	$35.98	$36.27	$0.29
92560	Bekesy audiometry; screening	$0.00	deleted code
92561	Bekesy audiometry; diagnostic	$39.22	deleted code
92562	Loudness balance test, alternate binaural or monaural	$44.72	$52.39	$7.67
92563	Tone decay test	$30.79	$35.93	$5.14
92564	Short increment sensitivity index (SISI)	$23.66	deleted code
92565	Stenger test, pure tone	$16.85	$23.51	$6.66
92567	Tympanometry (impedance testing)	$15.88	$15.45	($0.43)
92568	Acoustic reflex testing, threshold	$14.90	$15.45	$0.55
92570	Acoustic immittance testing, includes tympanometry (impedance testing), acoustic reflex threshold testing, and acoustic reflex decay testing	$31.11	$31.90	$0.79
92571	Filtered speech test	$26.58	$35.26	$8.68
92572	Staggered spondaic word test	$35.97	$51.05	$15.08
92575	Sensorineural acuity level test	$66.44	$81.27	$14.83
92576	Synthetic sentence identification test	$35.97	$47.02	$11.05
92577	Stenger test, speech	$15.23	$23.17	$7.94
92579	Visual reinforcement audiometry (VRA)	$44.08	$44.33	$0.25
92582	Conditioning play audiometry	$72.60	$95.04	$22.44
92583	Select picture audiometry	$48.94	$62.13	$13.19
92584	Electrocochleography	$115.38	$105.12	($10.26)
92587	Distortion product evoked otoacoustic emissions; limited evaluation (to confirm the presence or absence of hearing disorder, 3-6 frequencies) or transient evoked otoacoustic emissions, with interpretation and report	$21.07	$21.16	$0.09
TC		$3.89	$3.36	($0.53)
PC		$17.18	$17.80	$0.62
92588	Distortion product evoked otoacoustic emissions; comprehensive diagnostic evaluation (quantitative analysis of outer hair cell function by cochlear mapping, minimum of 12 frequencies), with interpretation and report	$32.41	$32.91	$0.51
TC		$5.19	$4.70	($0.49)
PC		$27.22	$28.21	$0.99
92601	Diagnostic analysis of cochlear implant, patient younger than 7 years of age; with programming	$157.51	$155.83	($1.68)
92602	Diagnostic analysis of cochlear implant, patient younger than 7 years of age; subsequent reprogramming	$100.47	$98.07	($2.40)
92603	Diagnostic analysis of cochlear implant, age 7 years or older; with programming	$147.14	$146.76	($0.38)
92604	Diagnostic analysis of cochlear implant, age 7 years or older; subsequent programming	$89.45	$87.99	($1.46)
92620	Evaluation of central auditory function, with report; initial 60 minutes	$88.48	$88.33	($0.15)
92621	Evaluation of central auditory function, with report; each additional 15 minutes (List separately in addition to code for primary procedure)	$21.07	$21.49	$0.42
92625	Assessment of tinnitus (includes pitch, loudness matching, and masking)	$65.79	$66.83	$1.04
92626	Evaluation of auditory rehabilitation status; first hour	$85.24	$85.64	$0.40
92627	Evaluation of auditory rehabilitation status; each additional 15 minutes (List separately in addition to code for primary procedure)	$20.09	$20.15	$0.06
92640	Diagnostic analysis with programming of auditory brainstem implant, per hour	$107.60	$108.14	$0.54