Centers for Medicare and Medicaid Services (CMS)

Centers for Medicare and Medicaid Services (CMS)

Audiology Quality Consortium Joint Announcement—Merit-Based Incentive Payment System and Healthmonix

The Audiology Quality Consortium (AQC), comprised of nine representative audiology organizations, has worked over the last year to create new, audiology-specific quality performance outcome measures that could be used in the Merit-Based Incentive Payment System (MIPS).

These measures represent additional options for reporting, a supplement to the nine extant measures available in the Centers for Medicare and Medicaid Services (CMS) designated MIPS measures set for audiology.

CMS Announces Claims Hold

In anticipation of possible congressional action to suspend the two percent budget sequestration cut slated to take effect April 1, 2021, the Centers for Medicare and Medicaid Services (CMS) has instructed the Medicare Administrative Contractors (MACs) to hold all claims with dates of service on or after April 1, 2021, for a short period without affecting providers’ cash flow.  Further information from CMS will be posted here as it becomes available. Congress is expected to act on this issue in mid-April.

FY21 Omnibus Appropriations Bill Benefits Audiology Medicare Reimbursement

On January 11, Health and Human Services (HHS) Secretary Alex Azar extended the COVID-19 Public Health Emergency (PHE) declaration effective January 21, 2021, for an additional 90 days. This means that all of the telehealth and other waivers and flexibilities that have been implemented during the PHE will remain in effect until at least April 21, 2021.

Final Stimulus Package Includes Partial Relief from 2021 Medicare Reimbursement Cuts to Audiology

On December 21, 2020, Congress passed a new stimulus package that includes provisions to mitigate planned Medicare reimbursement cuts for a variety of providers, including audiologists. 

Academy Encourages CMS to Allow Audiologists to Use Medicare Online Assessment “G” Codes

The Academy has delivered a letter to the Centers for Medicare and Medicaid Services (CMS) urging them to issue a Correction Notice to the 2021 Physician Fee Schedule to add audiologists to the list of providers able to use online assessment “G” codes designed for practitioners who are not authorized to perform evaluation and management (“E&M”) services. 

Illustration of coding and reimbursement for audiology

CODING AND REIMBURSEMENT | Deciphering Medicare Advantage Hearing Benefits

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)

Academy Submits Comments to CMS Regarding CY21 Medicare PFS

The Academy submitted comments to the Administrator of the Centers for Medicare and Medicaid Services (CMS) on October 4, 2020, in response to the proposed rule for the CY21 Medicare Physician Fee Schedule (PFS).  

The comments highlighted several provisions that would adversely impact practicing audiologists and the Medicare beneficiaries they treat.  

Congress Must Act to Halt Medicare Payment Cuts and Avoid Further Damage to the U.S. Health-Care System

August 17, 2020: A message from Paul Pessis, AuD

Practice Policy Advisory Committee Member

Close-up of of social security card and money

CODING AND REIMBURSEMENT | What Is the Social Security Number Removal Initiative and What Does It Mean to Audiologists?

Unfortunately, identity theft is something that we all need to think about these days. Medical identity theft is defined by the Office of the Inspector General (OIG) as when someone steals personal information such as a name, a social security number, or a Medicare number and uses it to obtain medical care, purchase drugs, or submit fake claims to Medicare.

Topic(s): Coding, Reimbursement, Medicare, Centers for Medicare and Medicaid Services (CMS)


Publication Issue: Audiology Today September/October 2017

The Academy and Other Provider Groups Call Upon Congress to Block Expected 2021 Medicare Cuts

The 2021 Proposed Medicare Physician Fee Schedule was released earlier this week (August 3) and the Academy has prepared a summary for members to review.  

In this proposed rule, CMS reiterated its plan to move forward with cuts to a wide variety of providers—both physician and non-physician—to counterbalance increases to primary care providers.  

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