Given that the Over-the-Counter (OTC) Hearing Aid Act of 2017 is now law and a new FDA class of OTC hearing aids will be established by the end of 2020, “efforts should now focus on ensuring that older adults also have access to affordable hearing care services,” write Nicholas Reed, AuD, Frank Lin, MD, and Amber Willink, PhD, in a September 13 online first opinion article in JAMA Network. Notably, Dr Lin has been one of the foremost leaders in research associating untreated hearing loss with cognitive decline, dementia, social isolation, falls, and an increased rate of hospitalization; he has also served on the NASEM Committee and been an advocate of OTC hearing aids and alternative distribution models, including the use of community healthcare workers.

The authors cite evidence showing that, while some consumers should benefit from a self-fitted OTC hearing device, others may not be able to adjust or self-manage their hearing devices. Additionally, those who receive care from professionals who use best practices, which includes counseling on communication strategies, experience enhanced benefit from amplification. They also note that most hearing care services are not covered by Medicare, and numerous bills have attempted to improve access, including the current Audiology Patient Choice Act (APCA) which lays the groundwork for audiologists gaining limited license physician (LLP) status (see the April 24, 2018 report in Hearing Review for more information and the controversy surrounding APCA).

Reed and colleagues suggest that a good solution might be to allow audiologists to bill for time-based aural rehabilitation via the existing aural rehabilitation CPT code 92626 for the first hour, and 92627 for each additional 15-minute increment, or co-opt CPT codes used by speech-language pathologists.  They write:

“Medicare reimburses speech-language pathologists for aural rehabilitation (CPT code 92507 at $79.92) under Medicare Part B; however, speech-language pathologists do not provide these services in relation to hearing aids and generally focus only on the communication counseling aspect. Audiologists could use the same CPT code (92507) for aural rehabilitation under Medicare Part B to provide communication counseling and auditory training, which would require hearing care to be redefined in the Medicare Act as medically necessary. Although these CPT codes would not necessarily support activities related directly to hearing aids (ie, programming and customization), these codes could support counseling to maximize benefit of OTC hearing aids among Medicare beneficiaries.”

Read the opinion article here.

Source: Reed NS, Lin FR, Willink A. Hearing care access? Focus on clinical services, not devices. JAMA Network. 2018. Published September 13, 2018. doi:10.1001/jama.2018.11649.  Available at: