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November 22, 2023

Two New CPT Codes Added for Use with AB Modifier in Limited Direct Access

  • Coding and Reimbursement

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 provider (NPP) order. The following codes are effective January 1, 2024:

  1. CPT code 92622—Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; first 60 minutes 
  2. CPT code 92623—Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; each additional 15 minutes (list separately in addition to code for primary procedure)

These new codes join the list of 36 other audiology codes designated as eligible to use with the AB modifier once every 12 months. During the CY 2023 Physician Fee Schedule (PFS) rulemaking, CMS finalized a regulation allowing audiologists to provide certain diagnostic tests for non-acute hearing conditions and diagnostic services related to implanted auditory prosthetic devices without a physician or NPP order.

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