Page 103 - Medicare Benefit Policy Manual

same date of service for different and separate tests from 96102, 96103, 96119 and
96120.

Under the physician fee schedule, there is no payment for services performed by students
or trainees. Accordingly, Medicare does not pay for services represented by CPT codes
96102 and 96119 when performed by a student or a trainee. However, the presence of a
student or a trainee while the test is being administered does not prevent a physician, CP,
IPP, NP, CNS or PA from performing and being paid for the psychological test under
96102 or the neuropsychological test under 96119.

80.3 - Audiology Services
(Rev. 132, Issued: 09-03-10, Effective: 09-30-10, Implementation: 09-30-10)

References.

1861(ll)(3) of the Social Security Act for the definition of audiology services.

1861(ll)(4)(B) of the Social Security Act for qualifications of audiologists.

42 CFR 410.32(b) for the physician supervision requirements for diagnostic tests.

Pub. 100-04, chapter 12, section 30.3 for coding and billing information related to
audiological services and aural rehabilitation.

Pub. 100-02, chapter 15, sections 220 and 230 for the physical therapy and speech-
language pathology policies relative to aural rehabilitation and balance, section 60 for
services incident to a physician’s service, and section 80.6 for policies relevant to
ordering for diagnostic tests.

Pub. 100-02, chapter 16, section 100 for hearing aid policies.

A list of audiology services is found at: www.cms.gov/therapyservices.

A. Benefit.

Hearing and balance assessment services are generally covered as “other diagnostic tests”
under section 1861(s)(3) of the Social Security Act. Hearing and balance assessment
services furnished to an outpatient of a hospital are covered as “diagnostic services”
under section 1861(s)(2)(C).

As defined in the Social Security Act, section 1861(ll)(3), the term “audiology services”
specifically means such hearing and balance assessment services furnished by a qualified
audiologist as the audiologist is legally authorized to perform under State law (or the
State regulatory mechanism provided by State law), as would otherwise be covered if
furnished by a physician.