Question
Can an independant audiologist whose practice is located in the same building as a physician bill for medicaid and medicare without any physician referral(for all services, please)?
Answer
Medicare requires a physician referral for all audiology services (Section 2070.3 of the Medicare Carriers Manual). State Medicaid programs must follow federal regulations that are described for individuals with speech, hearing, and language disorders (42 CFR 440.110(c)). These include ''...for which the patient is referred by a physician or other licensed practitioner of the health arts within the scope of his or her practice under State law.''
Steven C. White, PhD Director Health Care Economics and Advocacy American Speech-Language-Hearing Association 10801 Rockville Pike Rockville, MD 20852 phone 301-897-0126 fax 301-897-7356 email swhite@asha.org www.professional.asha.org
Steven C. White, PhD, CCC-A
Director of the Health Care Economics and Advocacy at the ASHA National Office.
Steven C. White, PhD, CCC-A, is the Director of the Health Care Economics and Advocacy at the ASHA National Office. White, an ASHA Fellow, is ex officio to the Health Care Economics Committee. His responsibilities include Medicare, private health insurance and Medicaid especially coding and outpatient reimbursement policies as they relate to these payers. White is the staff liaison to the American Medical Association Current Procedural Terminology Editorial Panel and the AMA Relative Value Update Committee. He has published and presented extensively on third party reimbursement. White is co-author with Janet McCarty of Health Plan Coding and Claims Guide (2005), Negotiating Health Care Contracts and Calculating Fees (2004), Appealing Health Plan Denials, and Getting Your Services Covered. White is also coauthor with Ingrida Lusis and Mark Kander of the Medicare Handbook for Audiologists (2005). White holds a PhD in audiology from Wayne State University and an MS in speech-language pathology and audiology from Ithaca College.
Related Courses
1https://www.audiologyonline.com/audiology-ceus/course/understanding-privilege-for-healthcare-professionals-36096Understanding Privilege, for Healthcare ProfessionalsSystems of privilege have created a wide division of inequality. This course will help hearing care professionals identify their privilege and determine how to make a difference in their places of employment.auditory, textual, visual129USDSubscriptionUnlimited COURSE Access for $129/yearOnlineOnlyAudiologyOnlinewww.audiologyonline.comUnderstanding Privilege, for Healthcare ProfessionalsSystems of privilege have created a wide division of inequality. This course will help hearing care professionals identify their privilege and determine how to make a difference in their places of employment.36096OnlinePT60M
Systems of privilege have created a wide division of inequality. This course will help hearing care professionals identify their privilege and determine how to make a difference in their places of employment.
2https://www.audiologyonline.com/audiology-ceus/course/creating-leadership-in-audiology-through-37632Creating Leadership in Audiology Through a Mentoring CircleThere are so many components to quality patient care that it is challenging to “master” them all. What if you could come together with other professionals who possess knowledge or experience that could help you or your practice? There are a number of veteran audiologists as well as rising professionals who have wisdom, qualifications, narratives, and unique journeys to share. The purpose of this talk is to rethink the traditional mentor/mentee vertical relationship and explore collaboration in the form of circle…where all professionals, regardless of age or experience, learn from each other.auditory, textual, visual129USDSubscriptionUnlimited COURSE Access for $129/yearOnlineOnlyAudiologyOnlinewww.audiologyonline.comCreating Leadership in Audiology Through a Mentoring CircleThere are so many components to quality patient care that it is challenging to “master” them all. What if you could come together with other professionals who possess knowledge or experience that could help you or your practice? There are a number of veteran audiologists as well as rising professionals who have wisdom, qualifications, narratives, and unique journeys to share. The purpose of this talk is to rethink the traditional mentor/mentee vertical relationship and explore collaboration in the form of circle…where all professionals, regardless of age or experience, learn from each other.37632OnlinePT60M
There are so many components to quality patient care that it is challenging to “master” them all. What if you could come together with other professionals who possess knowledge or experience that could help you or your practice? There are a number of veteran audiologists as well as rising professionals who have wisdom, qualifications, narratives, and unique journeys to share. The purpose of this talk is to rethink the traditional mentor/mentee vertical relationship and explore collaboration in the form of circle…where all professionals, regardless of age or experience, learn from each other.
3https://www.audiologyonline.com/audiology-ceus/course/core-topics-for-audiology-assistants-37123Core Topics for Audiology AssistantsThis course includes one hour of content on each of the following topics: 1) ethical concepts and decision-making; 2) universal safety precautions, including the Occupational Safety & Health Administration's (OSHA) bloodborne pathogens standard, and 3) patient confidentiality and the Health Insurance Portability & Accountability Act (HIPAA).auditory, textual, visual129USDSubscriptionUnlimited COURSE Access for $129/yearOnlineOnlyAudiologyOnlinewww.audiologyonline.comCore Topics for Audiology AssistantsThis course includes one hour of content on each of the following topics: 1) ethical concepts and decision-making; 2) universal safety precautions, including the Occupational Safety & Health Administration's (OSHA) bloodborne pathogens standard, and 3) patient confidentiality and the Health Insurance Portability & Accountability Act (HIPAA).37123OnlinePT180M
This course includes one hour of content on each of the following topics: 1) ethical concepts and decision-making; 2) universal safety precautions, including the Occupational Safety & Health Administration's (OSHA) bloodborne pathogens standard, and 3) patient confidentiality and the Health Insurance Portability & Accountability Act (HIPAA).
4https://www.audiologyonline.com/audiology-ceus/course/engaging-deaf-professionals-in-ehdi-37893Engaging Deaf Professionals in the EHDI SystemThe course explores ways to draw on Deaf professionals' expertise in working with families of Deaf and hard of hearing infants and young children. A highlight of Deaf people's knowledge, experiences, expertise, and contributions in the EHDI (Early Hearing Detection and Intervention) System will be discussed.auditory, textual, visual129USDSubscriptionUnlimited COURSE Access for $129/yearOnlineOnlyAudiologyOnlinewww.audiologyonline.comEngaging Deaf Professionals in the EHDI SystemThe course explores ways to draw on Deaf professionals' expertise in working with families of Deaf and hard of hearing infants and young children. A highlight of Deaf people's knowledge, experiences, expertise, and contributions in the EHDI (Early Hearing Detection and Intervention) System will be discussed.37893OnlinePT60M
The course explores ways to draw on Deaf professionals' expertise in working with families of Deaf and hard of hearing infants and young children. A highlight of Deaf people's knowledge, experiences, expertise, and contributions in the EHDI (Early Hearing Detection and Intervention) System will be discussed.
5https://www.audiologyonline.com/audiology-ceus/course/innovative-audiologic-care-delivery-38661Innovative Audiologic Care DeliveryThis four-course series highlights the next generation of audiology innovators and their pioneering approaches to meeting unmet audiologic needs in their communities and beyond. This peer-to-peer educational series highlights researchers, clinicians, and business owners and their pioneering ideas, care delivery models, and technologies which provide desperately needed niche services and audiologic care.auditory, textual, visual129USDSubscriptionUnlimited COURSE Access for $129/yearOnlineOnlyAudiologyOnlinewww.audiologyonline.comInnovative Audiologic Care DeliveryThis four-course series highlights the next generation of audiology innovators and their pioneering approaches to meeting unmet audiologic needs in their communities and beyond. This peer-to-peer educational series highlights researchers, clinicians, and business owners and their pioneering ideas, care delivery models, and technologies which provide desperately needed niche services and audiologic care.38661OnlinePT240M
This four-course series highlights the next generation of audiology innovators and their pioneering approaches to meeting unmet audiologic needs in their communities and beyond. This peer-to-peer educational series highlights researchers, clinicians, and business owners and their pioneering ideas, care delivery models, and technologies which provide desperately needed niche services and audiologic care.
