Monthly Archives: January 2024

Female audiologist with female patient

Medicare Updates and Audiology Changes for 2024

New Bone Anchored Codes and Payment Adjustments

Key Takeaways:

  • Starting January 1, 2024, audiologists will be able to bill for diagnostic analysis, programming, and verification of auditory osseointegrated devices (92622 & 92623)
  • The codes are timed codes with 92622 representing the first hour of service and 92623 serving as additional 15-minute increments
  • The CMS has lowered their conversion factor to $32.74, making the reimbursement for 92622 & 92623 $77.59* and $19.97* respectively

 The Centers for Medicare & Medicaid Services (CMS) has proposed significant changes for audiology services in 2024. Audiologists will see the introduction of two new timed codes effective January 1, 2024, which describe the analysis, programming, and verification of an auditory osseointegrated sound processor like the Ponto bone anchored hearing system (BAHS). Additionally, the CMS has proposed payment adjustments and continued telehealth coverage. Let’s dive into the details.

New Auditory Osseointegrated Device (AOD) Services Codes

Starting from January 1, 2024, audiologists will be able to use two new CPT codes for Auditory Osseointegrated Device (AOD) services. These codes are designed to cover the diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor:

  • 92622: Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; first 60 minutes.
  • 92623: Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; each additional 15 minutes (use 92623 in conjunction with 92622).

A keynote is that these codes are applicable to audiologists without a physician’s referral for a non-acute hearing condition. Furthermore, they include tasks such as attachment of the processor, device feedback calibration, device programming, and verification of processor performance for various types of auditory osseointegrated sound processors.

Important Points about AOD Services

  • Timed Codes: The new codes, 92622 and 92623, are timed codes that describe the first hour and each subsequent 15 minutes of time spent on the analysis, programming, and verification of an auditory osseointegrated sound processor.

If an evaluation lasts less than 30-minutes, 92623 (code indicating additional 15 minutes) should not be billed independently from 92622. Additionally, the -52 modifier should also not be used with 92622 or 92623 in this case. Instead, 92700 (unlisted Otorhinolaryngological Service or Procedures) can be used with the proper documentation and justification.

  • Reprogramming: These codes may also be used for reporting subsequent reprogramming of AODs.
  • Restrictions: Notably, CPT codes 92626 and 92627 may not be reported in conjunction with 92622 and 92623.

Medicare Physician Fee Schedule (PFS) Changes and Reimbursement

CMS has adjusted the Medicare Physician Fee Schedule (PFS) for the calendar year 2024. Key highlights include an overall payment rate reduction of 1.25 percent in calendar year (CY) 2024 compared to CY 2023. The final CY 2024 PFS conversion factor is $32.74, representing a decrease of $1.15 (or 3.4 percent) from the CY 2023 conversion factor of $33.89.

*According to the American Academy of Audiology, the “CY 2024 Final Payment” for non-facilities for the new service codes will be as follows. Note final reimbursement is dependent on your locality:

  • 92622 –  $77.59
  • 92623 – $19.97

Click the links below for more information regarding these important changes:

Microsoft Word – Audiology MPFS Final CY 2024.Table.docx

Medicare Proposes New Codes and Reporting Measures, Payment Cuts, and Continued Telehealth Coverage for 2024 (asha.org)

Calendar Year (CY) 2024 Medicare Physician Fee Schedule Proposed Rule | CMS

Medicare Finalizes CY 2024 Payment Rules – American Academy of Audiology

*Content updated 3/26/24