Reimbursement

Reimbursement

Woman working on laptop

CODING AND REIMBURSEMENT | From Student to Practitioner: Administrative Steps to Take After Graduation

For graduates of AuD programs across the country, understanding the steps required to become an independent audiologist can be helpful for a smooth transition from student to practitioner.

Topic(s): Coding, Reimbursement, audiology, NPI Number

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.

Illustration representing coding and reimbursement

CODING AND REIMBURSEMENT | CPT Coding Changes for 2021: Auditory Evoked Potentials and Vestibular Evoked Myogenic Potentials

Introduction

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

Photograph of a group of metallic numbers

Audiology Fee Schedules: What We Can Learn from the Medicare Database

Pricing Thoughts Overview

  • How do you set your fees?
  • How much is too much and how much is not enough?

For diagnostics, some audiologists may look at the fee schedule provided by third parties such as Medicare and wonder if those fees should be the fees for all patients.

For products, audiologists may use manufacturers’ suggested retail pricing to determine how much should be charged.

Topic(s): Coding, Reimbursement, audiology

Summary of MPFS CY2021 and Call to Action for Audiology

The Centers for Medicare and Medicaid Services (CMS) issued the final 2021 Medicare Physician Fee Schedule (MPFS) on December 2, 2020. Unfortunately, CMS failed to provide relief from a significant shift in physician and non-physician payments slated to take effect on January 1, 2021. This change is estimated to impact audiology services by -6 percent.

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)

Photo of a magnifying glass laid on a sheet of codes

CODING AND REIMBURSEMENT | Increase Your Coding Specificity with New ICD-10-CM Codes

On October 1, 2016, new ICD-10-CM codes were released that increase the specificity of hearing loss codes, applying specifically to coding the type of hearing loss when it differs between ears. Previously, when the types of hearing loss differed between ears, audiologists were required to code an unspecified type of hearing loss for each ear and could not specify right versus left ears in this scenario (i.e. sensorineural hearing loss, unspecified; conductive hearing loss, unspecified; mixed hearing loss, unspecified).

Topic(s): Coding, Reimbursement

Photo of directional sign that says, "Changes Ahead"

CODING AND REIMBURSEMENT | Important Changes to Quality Reporting for 2017

Did you know that at the end of 2016, the Physician Quality Reporting System (PQRS) ended and was replaced by CMS’ new Quality Payment Program (QPP)? This means that 2016 was the final year in which providers, including audiologists, were eligible to participate in the PQRS program. 

Topic(s): Coding, Reimbursement

Author(s): 

Publication Issue: Audiology Today March/April 2017

Illustration for email advocacy

CODING AND REIMBURSEMENT | Communication with the Coding and Reimbursement Committee: How Members Contribute to Payer-Policy Advocacy

Many of you may be familiar with, or may have even used, the Academy’s e-mail box for submitting coding, reimbursement, and compliance-related questions. This centralized mailbox (reimbursement@audiology.org) allows the Academy’s Coding and Reimbursement Committee (CRC) to review and discuss all inquiries posed to the Academy. The CRC is able to research, discuss, and vet responses to questions received. Having a centralized system for answering questions serves many purposes.

Topic(s): Coding, Reimbursement, Advocacy

Author(s): 

Publication Issue: Audiology Today May/June 2017