RESTON, Va — Audiologists will receive a 2% increase in aggregate Medicare payments in 2008, according to the Medicare physician fee schedule rule released November 1 by the Centers for Medicare and Medicaid Services (CMS). In addition, eight audiology CPT codes (comprehensive hearing testing, acoustic reflex threshold testing, reflex decay testing, visual reinforcement audiometry, and the four cochlear implant programming codes) will now be valued through the professional work value of the fee schedule as opposed to the practice expense component. This shows CMS’s recognition that these services should be valued in the same manner as services provided by physicians, psychologists, optometrists, physical therapists, and other health care professionals, according to the American Academy of Audiology (AAA).

The Academy strongly supported the assignment of professional work values for these services and surveyed audiologists to determine the time and professional skills involved in these procedures. Although the Academy says that it is pleased with CMS’s decision to assign work values for these codes, it disagrees with the work values assigned in the final rule. The values assigned in the final rule undervalue audiology services, says AAA, and will result in significant cuts in payment for these services beginning in 2010.

The Academy was alerted to the work values proposed for these services when CMS published the proposed physician fee schedule rule July 12. After publication of the proposed rule, AAA took action to ensure these audiology services were appropriately valued by submitting extensive comments to CMS and meeting in person with CMS officials. In comments to the proposed fee schedule rule submitted August 31 and in the meeting, the organization stated that CMS should revisit the proposed work values for these codes in order to determine appropriate values for these services. The Academy further contended that there should be an opportunity to obtain additional data and further input from all affected groups regarding the resources needed to furnish these services.

As a direct result of the comments submitted, the Academy was invited to represent the specialty of audiology in a CMS multi-specialty refinement panel meeting held October 4. The purpose of the refinement panel was to reexamine the values for CPT codes 92557 and 92579.

The Academy reports that it has taken a number of actions to prevent cuts in payment for audiology services from occurring in 2010 and will continue to work aggressively to stop these projected reductions in payment. It is analyzing the 1,481-page rule and a more detailed summary of provisions in the rule will be available soon.

SOURCE: American Academy of Audiology