By Susan Von Dollen, Anna M. Jilla, and Carrie Kovar
This article is a part of the January/February 2023, Volume 35, Number 1, Audiology Today issue.
The Medicare Physician Fee Schedule (MPFS), first implemented in 1992, is the payment system used to determine Medicare reimbursement for covered services and is often the template adopted by other health-care payers. The 2023 MPFS brings some significant changes for audiology practice, including a limited direct access provision for select audiology services. The MPFS final rule for calendar year 2023 goes into effect on January 1, 2023.
Limited Direct Access
Beginning January 1, 2023, Centers for Medicare and Medicaid Services (CMS) will allow Medicare beneficiary access to 36 audiology services (see TABLE 1) without a physician order, once every 12 months through use of a new “AB” modifier. Earlier in 2022, CMS had proposed to create a single, new G-code to replace individual Current Procedural Terminology (CPT) codes for services provided by an audiologist without a physician order.
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