decisionhealth Newsletters, Answer Books - 2008 Issue 5 (May)
Medicare_Carriers_Manual / 2070 / 2070.3_Otologic_Evaluations.--
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Article Overview
This article explains Medicare coverage policy for diagnostic hearing and balance testing performed by qualified audiologists when ordered by a physician as part of evaluating hearing deficits or related medical problems. It also addresses when such testing is not covered, how reimbursement is handled, what qualifies an individual as a qualified audiologist, and where carriers may look for credential verification. The material is most relevant to audiologists, physicians, audiology practices, and billing or compliance staff working with Medicare coverage rules.
Why This Topic Matters
It helps providers and billing staff understand whether audiology diagnostic services fit within Medicare-covered diagnostic testing, how carrier review may depend on the stated purpose of the exam, and what qualification standards apply to the audiologist furnishing the service.
What You Will Learn
- How Medicare frames audiologist-performed diagnostic testing within coverage policy
- What general circumstances affect whether audiology diagnostic services are covered
- How reimbursement for covered audiology diagnostic services is handled at a high level
- What qualification criteria are associated with the term qualified audiologist
- Where carriers may verify audiologist credentials
- What services are noted as not covered in this context
Who Should Read This
- Audiologists
- Physicians
- Audiology billing staff
- Medical coders
- Medicare compliance staff
- Practice administrators
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