CMS issued additional guidance regarding the new provision for limited direct access to audiology services that will go into effect on January 1, 2023. As stated by CMS in this guidance,
This modification in our finalized policy requires multiple changes to our claims processing systems which will take some time to fully operationalize, possibly by July 2023. Until such time, however, for dates of service on or after January 1, 2023, audiologists may elect to use modifier AB, along with any of the 36 CPT codes on the finalized list, and following the safeguards built into modifier AB. Note: More information will be provided as it becomes available.
This same guidance also includes a list of audiology services covered under Medicare and clearly denotes which can be used with the AB modifier.
Visit the CMS guidance to access the code list and other explanations about the limited direct access benefit.
Related Posts
Two New CPT Codes Added for Use with AB Modifier in Limited Direct Access
The November 16, 2023, issue of MLN Matters provides the updated information to the Centers for Medicare and Medicaid Services (CMS) guidance “Allowing Audiologists to Provide Certain Diagnostic Tests Without a Physician Order.” The revised guidance now adds two new audiology codes to use with the AB modifier for direct access without a physician or non-physician…
Medicare Finalizes CY 2024 Payment Rules
Late November 2, 2023, the Centers for Medicare and Medicaid Services (CMS) released the final 2024 Medicare Physician Fee Schedule (MPFS) and 2024 Hospital Outpatient Prospective Payment System rules. The rules take effect January 1, 2024. MPFS High-Level Take-Aways Quality Payment Program (QPP) Provisions CMS has added two new measures (317 and 498) to the…
The MPFS CY24: What Does the Proposed Rule Mean for Audiology Payments?
The proposed rule for the Medicare Physician Fee Schedule (MPFS) for calendar year 2024 (CY24) shows another year of Medicare cuts for most providers, as reflected in the extensive red of the audiology code table included with a recent update from the Academy. The projected impact is a -2 percent cut overall for audiology codes…