Allowing Audiologists to Provide Certain Diagnostic Tests Without a Physician Order - Revised

Related CR Release Date: October 27, 2023 - Revised
Effective Date: July 1, 2023, except January 1, 2024, as noted in the Article
Implementation Date: July 3, 2023
MLN Matters Number: MM13055
Related Change Request (CR) Number: CR 13055 & CR 13279
Related CR Transmittal Number: R12091OTN & R12335OTN

Note: CMS added 2 new CPT codes effective January 1, 2024, based on CR 13279.

CR 13055 tells you about:

  • Limited to non-acute hearing conditions and diagnostic services related to implanted auditory prosthetic devices
  • Excludes audiology services that are related to disequilibrium, hearing aids, or examinations for the purpose of prescribing, fitting, or changing hearing aids
  • Covered once per patient per 12-month period
  • Unexpected discovery of an acute condition

Make sure your billing staffs knows about billing and coding requirements for these diagnostic tests using the AB modifier.

View the complete CMS Medicare Learning Network (MLN) Matters (MM)13055.

Last Updated Nov 16 , 2023