Tele-audiology Reimbursement

Tele-audiology Reimbursement

Currently there are more questions than answers on the topic of tele-audiology reimbursement. There are no standards on reimbursement. It is necessary to look at individual state laws (ASHA, 2012).

  1. Forty-four states have reimbursement (live-video procedures only) and seven states reimburse partly for store-and-forward applications.
  2. Fifteen states have telehealth legislation regarding private payers.
  3. Privately held insurance companies are not required to follow state laws on insurance coverage –only those who are “insurance companies” must comply.
  4. As of October 29, 2013, there were only 20 states plus the District of Columbia, that require insurance companies to pay for some form of telemedicine services: Arizona, California, Colorado, Georgia, Hawaii, Kansas, Louisiana, Maine, Maryland, Michigan, Minnesota, Mississippi, Montana, New Hampshire, New Mexico, Oklahoma, Oregon, Texas, Vermont, and Virginia.

Centers for Medicare and Medicaid Services (CMS)

  1. Medicare regulations do not include audiologists or speech pathologists as eligible providers for telemedicine.
  2. The telehealth Healthcare Common Procedure Coding System (HCPCS) codes recommended by CMS are not reimbursable for audiologists (G0425-G0427). However, some states’ Medicaid will reimburse all audiology codes with a GT modifier as long as there is justification for how services will be completed (e.g., hearing aid electroacoustic analysis and reprogramming would be feasible but earmold impressions would not).



American Speech-Language-Hearing Association. (2012) State Provisions Update for Telepractice. (accessed April 1, 2012).

Also of Interest