The American Academy of Audiology (the Academy), together with the American Speech-Language-Hearing Association (ASHA), continuously reviews the CPT code set applicable to audiologists. The goal is to ensure that audiologists have appropriate codes to report that accurately describe and reflect the services they perform for patients.
Topic(s): Coding, Reimbursement, audiology
Introduction to the Medicare Advantage Program
The Medicare Part C Program was developed following passage of the Balanced Budget Act of 1997 and went into effect in January of 1999. With identified gaps in coverage for Medicare beneficiaries, the addition of an optional Medicare program permitted the Centers for Medicare and Medicaid Services (CMS) to contract with private or public agencies to provide additional Medicare options for beneficiaries who wished to seek coverage in addition to original Medicare’s Part A and B benefits.
Topic(s): Coding, Reimbursement, audiology, Hearing Aids, Centers for Medicare and Medicaid Services (CMS)
In the era of COVID-19, it has become increasingly important to use different methods of clinical service provision to protect our patients’ health while still addressing their hearing, tinnitus, and vestibular health-care needs.
As audiology clinics increase their use of telehealth as a method for patient care, audiologists must understand how such changes also impact coding and billing. This article will discuss considerations and provide examples of billing and coding for telehealth services for audiologists.
Topic(s): Coding, reimbursment, Telehealth, tele-audiology, telemedicine
Billing modifiers were created to provide additional information to the payer about the performed procedure(s) and help describe and/or qualify the services provided. There are common modifiers used by commercial payers and the Centers for Medicare and Medicaid Services (CMS), that indicate to the payer that the services provided have been altered in a way that is different than the ascribed definition of the billing code. For example, a modifier should be used when all of the tests in a bundled code were not performed or when only one ear was tested.
Topic(s): Centers for Medicare and Medicaid Services (CMS), Medicare, Advance Beneficiary Notice (ABN), CPT - Current Procedural Terminology, Coding, Reimbursement, Practice Management, Patient care, Treatment