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CMS Confirms Interpretation Role of Audiologists

Originally posted to the American Speech-Language-Hearing Association Headlines e-mail list 4/14/05

In a revision to the Medicare Claims Processing Manual, released April 1, 2005, the Centers for Medicare and Medicaid Services (CMS) added "audiologist" when referring to the professional component of audiologic function tests. The clarification was provided as related to tests billed by a skilled nursing facility (SNF) or an audiologist for services rendered to a beneficiary in a Part B SNF stay.

"For tests that include both a professional component and technical component, the SNF may elect to bill the technical component to the FI [fiscal intermediary], but is not required to bill the service. (The professional component of a service is the direct patient care provided by the physician or audiologist, e.g., the interpretation of a test.)" [Medicare Claims Processing Manual : Chapter 5, Sec. 10. Transmittal
515: www.cms.hhs.gov/manuals/pm_trans/R515CP.pdf]

This action by CMS is supportive of ASHA's ongoing dialogue concerning valuation of audiology procedures using the work component rather than the technical component. The work component reflects the professional nature of the audiologist's services rather than the assistant's role valued in the technical component. For further information, contact Mark Kander, ASHA's Director of Health Care Regulatory Analysis, via e-mail at mkander@asha.org or by phone at 800-498-2071, ext. 4139; or Steve White, Director of Health Care Economics and Advocacy, via e-mail at swhite@asha.org or by phone at ext. 4126.

Reprinted by permission of the American Speech-Language-Hearing Association

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