The Academy of Doctors of Audiology (ADA), the American Academy of Audiology (the Academy), and the American Speech-Language-Hearing Association (ASHA) sent a joint letter to the Centers for Medicare and Medicaid (CMS) requesting the removal of the Medicare physician order requirement. 

The physician order requirement exceeds state scope of practice laws, impedes beneficiary access to care, and adds unnecessary cost to the program.

There is no statutory language that prohibits Medicare from allowing direct beneficiary access to audiologist services. Audiologists could also be added to the list of certain non-physician providers currently able to administer diagnostic tests without a physician order under 42 CFR 410.32(a)(2)(2016). 

HHS could also effect this change by amending the requisite Medicare manuals clarifying that audiologists are included in the list of non-physician providers under 42 CFR 410.32(a)(2)(2016).

On October 3, 2019, the Administration issued an Executive Order on Eliminating Medicare Regulations that Exceed State Scope of Practice Laws and Limit Health Professionals from Practicing at the Top of Their License (EO #13890). 

On May 19, 2020, the Administration issued an Executive Order on Regulatory Relief to Support Economic Recovery that directs regulatory agencies to identify those regulatory waivers that should remain permanent as well as other regulations that could be eliminated that would support economic recovery and increase patient access.

The physician order requirement exceeds state audiology scope of practice requirements in all 50 states. In addition, removing the physician order requirement would eliminate unnecessary physician visits and would provide tangible savings to the Medicare program.

Review the Joint Letter