Medicare Audiology FAQs Available Audiologists now have an additional resource for questions on Medicare billing: an online list of frequently asked questions and answers compiled by ASHA in collaboration with the Academy of Doctors of Audiology and the American Academy of Audiology. The FAQs, available on ASHA’s website, address the following topics: One FAQ, ... Bottom Line
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Bottom Line  |   March 01, 2011
Medicare Audiology FAQs Available
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Hearing Disorders / Practice Management / Bottom Line
Bottom Line   |   March 01, 2011
Medicare Audiology FAQs Available
The ASHA Leader, March 2011, Vol. 16, 7. doi:10.1044/leader.BML3.16032011.7
The ASHA Leader, March 2011, Vol. 16, 7. doi:10.1044/leader.BML3.16032011.7
Audiologists now have an additional resource for questions on Medicare billing: an online list of frequently asked questions and answers compiled by ASHA in collaboration with the Academy of Doctors of Audiology and the American Academy of Audiology.
The FAQs, available on ASHA’s website, address the following topics:
  • Getting started as a Medicare provider

  • Defining medically “reasonable and necessary” services

  • Opting out of Medicare

  • Participation options

  • Using the advanced beneficiary notice

  • Using billing code modifiers

  • Providing free hearing tests

  • Using practice-specific referral forms

  • Using reminder cards for hearing tests

  • Needing physician orders to perform an evaluation

  • Documentation requirements

  • Correct coding for use of electrodes

  • Correct coding for unilateral testing

One FAQ, for example, asks “What are the options for participation in Part B Medicare?” and provides the following answer:
“There are two categories of participation within Medicare: participating provider (who must accept assignment) and non-participating provider (who does not accept assignment).
“You may agree to be a participating provider with Medicare. Once enrolled, you are required to bill on an assignment basis and accept the Medicare allowable fee as payment in full. Medicare will accept 80% of the allowable amount of the Medicare Physician Fee Schedule (MPFS); the patient will pay a 20% co-insurance at the time services are rendered or ask you to bill his or her Medicare supplemental policy. Both participating and nonparticipating providers are required to file the claim to Medicare.
“As a nonparticipating provider you are permitted to decide on an individual claim basis whether or not to accept assignment or bill the patient on an unassigned basis. The allowable fee for a nonparticipating provider is reduced by 5% in comparison to a participating provider. Thus, if the allowable fee is $100 for a participating provider, the allowable fee for a nonparticipating provider is $95. Medicare will pay 80% of the $95. If assignment is accepted, the patient is responsible for 20% of the $95.”
For the full answer to this and other FAQs, visit the new website.
ASHA Access Audiology:NIDCD Report on Health Care

The March/April issue of ASHA Access Audiology will highlight the summary report and research recommendations of the National Institute on Deafness and Other Communication Disorders (NIDCD) Working Group on Accessible and Affordable Hearing Health Care for Adults with Mild to Moderate Hearing Loss. It also will feature funding opportunities now available through NIDCD following the working group recommendations.

ASHA Access Audiology is an electronic clinical newsletter published every other month.

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FROM THIS ISSUE
March 2011
Volume 16, Issue 3