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.
| 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 |
Additional Resources:
Fact Sheet on the CY 2022 Physician Fee Schedule Notice of Proposed Rule Making
CMS Press Release on the CY 2022 Physician Fee Schedule Proposed Rule
Federal Register Announcement 7.13.21 of the CY2022 Proposed Medicare Physician Fee Schedule
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