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December 14, 2022

Limited Direct Access to Audiology Services Under Medicare: Updated Information

  • Coding and Reimbursement

CMS issued additional guidance regarding the new provision for limited direct access to audiology services that will go into effect on January 1, 2023. As stated by CMS in this guidance,

This modification in our finalized policy requires multiple changes to our claims processing systems which will take some time to fully operationalize, possibly by July 2023. Until such time, however, for dates of service on or after January 1, 2023, audiologists may elect to use modifier AB, along with any of the 36 CPT codes on the finalized list, and following the safeguards built into modifier AB. Note: More information will be provided as it becomes available.

This same guidance also includes a list of audiology services covered under Medicare and clearly denotes which can be used with the AB modifier.

Visit the CMS guidance to access the code list and other explanations about the limited direct access benefit.

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