CMS Expands Telehealth Coverage for Audiologists, Speech-Language Pathologists

The Centers for Medicare & Medicaid Services has expanded Medicare coverage for certain audiology and speech-language pathology services delivered via telehealth during the coronavirus pandemic.

CMS this week added several Current Procedural Terminology (CPT) codes to the list of authorized codes during the public health emergency, giving audiologists and speech-language pathologists more leeway to use connected health tools and platforms to treat patients in Medicare Part B and Medicare Advantage plans.

“We applaud this week’s action by CMS,” A. Lynn Williams, PhD, CCC-SLP, president of the Speech-Language-Hearing Association, said in a press release. “Ever since the pandemic began, ASHA has advocated for additional telehealth services to ensure patient access to medically necessary care and to prevent the transmission of COVID-19 among seniors - individuals particularly vulnerable to the worst effects of the virus. This decision will allow them to obtain needed critical healthcare services in a way that is more accessible and safer.”

The following codes have been added to the list for covered audiology services during the PHE:

• 92550, Tympanometry and reflex threshold measurements
• 92552, Pure tone audiometry (threshold); air only
• 92553, Pure tone audiometry (threshold); air and bone
• 92555, Speech audiometry threshold
• 92556, Speech audiometry threshold; with speech recognition
• 92557, Comprehensive audiometry threshold evaluation and speech recognition
• 92563, Tone decay test
• 92565, Stenger test, pure tone
• 92567, Tympanometry (impedance testing)
• 92568, Acoustic reflex testing, threshold
• 92570, Acoustic immittance testing, includes tympanometry (impedance testing), acoustic reflex threshold testing, and acoustic reflex decay testing
• 92587, Distortion product evoked otoacoustic emissions; limited evaluation (to confirm the presence or absence of hearing disorder, 3-6 frequencies) or transient evoked otoacoustic emissions, with interpretation and report
• 92625, Assessment of tinnitus (includes pitch, loudness matching, and masking)
• 92626, Evaluation of auditory function for surgically implanted device(s) candidacy or postoperative status of a surgically implanted device(s); first hour
• 92627, Evaluation of auditory function for surgically implanted device(s) candidacy or postoperative status of a surgically implanted device(s); each additional 15 minutes.

And these codes have been added to the list of covered speech-language pathology services during the PHE:

• 92526, Treatment of swallowing dysfunction and/or oral function for feeding
• 92607, Evaluation for prescription for speech-generating augmentative and alternative communication device, face-to-face with the patient; first hour
• 92608, Evaluation for prescription for speech-generating augmentative and alternative communication device, face-to-face with the patient; each additional 30 minutes
• 92609, Therapeutic services for the use of speech-generating device, including programming and modification
• 92610, Evaluation of oral and pharyngeal swallowing function
• 96105, Assessment of aphasia (includes assessment of expressive and receptive speech and language function, language comprehension, speech production ability, reading, spelling, writing, eg, by Boston Diagnostic Aphasia Examination) with interpretation and report, per hour
• 96125, Standardized cognitive performance testing (eg, Ross Information Processing Assessment) per hour of a qualified health care professional's time, both face-to-face time administering tests to the patient and time interpreting these test results and preparing the report
• 97129, Therapeutic interventions that focus on cognitive function (eg, attention, memory, reasoning, executive function, problem solving, and/or pragmatic functioning) and compensatory strategies to manage the performance of an activity (eg, managing time or schedules, initiating, organizing, and sequencing tasks), direct (one-on-one) patient contact; initial 15 minutes
• 97130, Therapeutic interventions that focus on cognitive function (eg, attention, memory, reasoning, executive function, problem solving, and/or pragmatic functioning) and compensatory strategies to manage the performance of an activity (eg, managing time or schedules, initiating, organizing, and sequencing tasks), direct (one-on-one) patient contact; each additional 15 minutes (List separately in addition to code for primary procedure).

The codes are included in a resource page on the ASHA website that explains how providers can use telehealth during the pandemic.

The announcement comes almost a year after CMS first expanded the list of telehealth services covered by Medicare to address the COVID-19 crisis. At that time, the agency included a limited number of services for audiologists and SLPs, prompting an outcry from telehealth advocates and a handful of bills calling for more coverage, both during and after the pandemic.

Just last week, the Expanded Telehealth Access Act (HR 2168) was reintroduced to Congress after failing to make it through last year’s session. The bill, sponsored by several members of the House, would permanently expand Medicare coverage to telehealth services provided by physical and occupational therapists, audiologists and speech and language pathologists and allow the Health and Human Services Secretary to add to the list of healthcare providers who could use telehealth.

“The use of telehealth services during this crisis has demonstrated the critical role technology can play in improving health equity,” US Rep. Mikie Sherrill (D-NJ), a co-sponsor of last year’s bill as well as this year’s bill, said in a press release. “Even now, as vaccinations are being distributed and the country begins to hope for a post-pandemic future, the value of telehealth networks has never been clearer. No one should have to go without care when a video or phone conversation with a health care provider could mean quicker, safer medical attention.”