Tuesday, 06 April 2021

Medicare Expands Coverage via Telepractice/Telehealth

Posted in ADA News

Medicare has again expanded coverage of audiology services that are provided via telepractice/telehealth. Please note that, while this expansion of coverage is reviewed every 90 days during the public health emergency, it is expected to continue throughout 2021.

As you explore telepractice/telehealth in your own practices, please ensure that:

  • Your state allows for the provision of telehealth for audiologists in your state.
  • All of the requirements of the covered CPT code are able to be met via your telehealth delivery model.
  • Your practice has received consent, from the patient, to allow you to provide care to them via telehealth. This consent must be obtained annually.
  • Your practice has the technology and/or remote personnel to provide this procedure in a manner and to a level of efficacy that is consistent with the same service being provided in a face to face encounter.
  • If the item or service is in your scope of practice and allowed by licensure and not listed below, Medicare beneficiaries can still be charged privately for non-covered telehealth services.
    • 92550: Tympanometry and acoustic reflex testing
    • 92551: Screening test, pure tone, air only
      • Pass/fail
    • 92552: Pure tone audiometry (threshold); air only.
    • 92553: Pure tone audiometry (threshold); air and bone.
    • 92555: Speech audiometry threshold/awareness.
    • 92556: Speech audiometry threshold/awareness; with speech recognition.
    • 92557: Comprehensive audiometry threshold evaluation and speech recognition.
    • 92563: Tone decay test
    • 92565: Stenger test, pure-tone
    • 92567: Tympanometry
    • 92568: Acoustic reflex testing, threshold/eSRT
    • 92570: Tympanometry, acoustic reflex testing, and acoustic reflex decay.
    • 92587: Distortion product evoked otoacoustic emissions; limited evaluation (to confirm the presence or absence of hearing disorder, 3-6 frequencies) or transient evoked otoacoustic emissions, with interpretation and report
    • 92601: Diagnostic analysis of cochlear implant, patient younger than 7 years of age; with programming
    • 92602: Diagnostic analysis of cochlear implant, individual under 7 years of age; subsequent reprogramming.
    • 92603: Diagnostic analysis of cochlear implant, age 7 years or older; with programming
    • 92604: Diagnostic analysis of cochlear implant, age 7 years or older; subsequent reprogramming.
    • 92625: Assessment of tinnitus
    • 92626: Evaluation of auditory function for surgically implanted device(s) candidacy or postoperative status of a surgically implanted device(s); first hour
    • 92627: Evaluation of auditory function for surgically implanted device(s) candidacy or postoperative status of a surgically implanted device(s); each additional 15 minutes.

Please note that not all Medicare Administrative Contractor websites have kept pace with these telehealth coverage changes. You can view the Medicare coverage list at https://www.cms.gov/Medicare/Medicare-General-Information/Telehealth/Telehealth-Codes.