Audiology Resources
Monthly News & Updates
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2020 has been, for everyone, quite a year! I want to take this opportunity to thank my audiology friends, family and colleagues! Thank you for your emails, phone calls, Zoom meetings, texts, consulting projects, and boot camp and training module registrations! You make my work and business possible! I appreciate all of you very much!
For those of you who want to try to decrease your managed care headaches, increase productivity and profitability, expand your practice, its footprint, and its scope in 2021 or who just want to be better prepared and more informed, there are still spots available in the February 2021 Live Stream Boot Camp! Click below to learn more!
Let's start 2021 informed and healthy!
Cheers!
Kim
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Monthly Coding and Reimbursement Tips
2021 Medicare Updates
Medicare Allowable Rates
The 2021 Physician Fee Schedule Final Rule indicated an average 6 - 7% cut in allowable rate for all audiology services. Please consult your local Medicare fee schedule when available.
2021 Traditional Medicare Beneficiary Deductible
The 2021 traditional Medicare beneficiary deductible is $203.
Medicare Coverage of Telehealth
92601-92604 are the only procedures Medicare covers via telehealth.
When providing telehealth services, you will need to either change your place of service code to 02 OR add the 95 modifier (synchronous telemedicine service rendered via a real-time audio and video telecommunications system). Please consult your payer guidance for which approach they recommend. Using the wrong approach can and will affect allowable rates.
Merit Based Incentive Payment System (MIPS)
The MIPS requirements are unchanged for 2021. The low volume threshold remains as:
- Dollar Amount ($90,000) or
- Number of Beneficiaries (200) or
- Number of Covered Professional Services (200)
An individual provider must exceed all of these thresholds in order to be required to report MIPS.
The nine audiology MIPS measures for 2021 are:
- Documentation of Current Medications in the Medical Record
- Preventive Care and Screening: Screening for Depression and Follow-Up Plan
- Falls: Risk Assessment
- Falls: Plan of Care
- Referral for Otologic Evaluation for Patients with Acute or Chronic Dizziness
- Preventative Care and Screening: Tobacco Use: Screening and Cessation Intervention
- Elder Maltreatment Screen and Follow-Up Plan
- Already a requirement of many state audiology licensure acts.
- Functional Outcome Assessment
- Falls: Screening for Future Falls Risk
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Research Spotlight
There has been a huge focus on the ties between cognition and hearing loss in 2020. But, one concern I have, is not enough focus on the science of cognition, hearing and communication, evidence based screening, and how this integrates into communication and functional needs assessments and their resulting comprehensive care plans. It cannot be about hearing aid sales.
It is also important to read the clinical data available from cognition screening vendors, such as Cognivue .
There is also great research in this space being done abroad. Here is but a sampling of the research on hearing and cognition:
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Tackling the Biggest Challenges Facing Audiology and Its Future One Month at a Time: Audiology Status in Healthcare
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In my August 2020 newsletter, I posed this poll question: In your opinion, what is the biggest challenge facing Audiology and its future? The third largest response selected (over 18%) was “Audiology Status in Healthcare”. You can view the poll results HERE.
Audiologists constantly lament our status within healthcare and how we are viewed by administrators, physicians, legislators, manufacturers, advocates, and consumers. The problem is that, while most audiologists have complaints, only a small percentage devote the financial and human resources needed to move audiology's status forward and have it reflect that of a doctoring profession.
Our scope of practice is dictated by our state licensure laws and rules. Almost every state and territory has a state audiology association or state speech and hearing association. It is these organizations that champion licensure changes. These organizations need members in order to fund the lobbying, legislative and regulatory activities required to evolve our scope of practice. Lobbyists, at the state level, cost $15K - $50K A YEAR! Unfortunately, only about 20-25% of audiologists are members of their state association. As a result, state associations struggle to be able to fund the activities needed to make an impact on our role and status in healthcare at the state level.
At the national level, the Medicare Audiologist Access and Services Act (MAASA) was introduced in the 116th Congress. This bill, which would drastically elevate our status within the Medicare system (which other payers base their policies upon) and allow for recognition and coverage of our full scope of practice. Maintaining this legislative initiative and moving the bills forward requires significant human and financial resources. DC lobbying firms and lobbying activities cost $150K+ a year. None of us pay enough in dues to national associations to fund these types of necessary legislative changes. We have to raise money! Also, since we are represented by three major organizations because audiologists support multiple associations rather than just one, these resources are being split amongst varying groups. Sometimes we are paying to fight each other.
Also, many in the audiology community allowed our status to be further diminished during COVID. WE condoned directives that deemed us non-essential and, in turn, diminished the value of audiologists and audiology, communication, hearing and balance in healthcare. We should have fought tooth and nail to be deemed essential healthcare providers in our states and localities and fought for the RIGHT and OPPORTUNITY to remain open and available to our patients (if we had the personal protective equipment, personal health status and resources to do so). This "non-essential" communication could haunt us moving forward as we fight to be recognized as doctoring professionals.
Finally, our own actions and communications, in our own communities, affects and influences our status within healthcare. Some of us use marketing and operational tactics that encourage individuals to perceive us more as product retailers and less as healthcare providers. We do not offer evidenced based, comprehensive evaluative and management services related to hearing, communication, tinnitus and balance. We focus little to no resources on prevention. We have tied our entire identity to selling a retail product rather than having the product be a tool and treatment option in a comprehensive audiologic care plan.
We, the audiology community, can have a significant impact on how we are perceived and valued and our status and role within the healthcare system. Here are a few opportunities that could have a profound effect on our status in healthcare:
- Every audiologist should join their state audiology association. If every audiologist joined their state association, their revenues would increase by 75%+.
- Every audiologist should donate at least $100 to their state association to fund lobbying activities. In an average state, this would add $40K to the bottom line.
- State audiology associations should tackle licensure law revisions to reflect current practice. Most have not been updated since 2007, when the AuD language was first added.
- Every audiologist should write their US Senators and US Representative in support of MAASA (http://www.chooseaudiology.org/congressional-connect).
- Every audiologist should donate at least $100 to a PAC or capital fund though a national association they support (AAA, ASHA or ADA). If every audiologist gave at least $100 a year, this would give audiology $1.5 million dollars to use for advocacy and awareness each year.
- Audiologists should work with their state audiology association to fight to be considered an essential healthcare provider in their state.
- Audiologists should consistently provide evidence based evaluation and treatment of auditory, communication and balance disorders.
- Audiologists should consistently practice to the top of their license and scope of practice.
- Audiologists should voluntarily participate in quality reporting programs and activities, such as the Merit Based Incentive payment system. We need data to show our value.
- Audiologists should market prevention, audiology, and audiologic and vestibular care, and services rather than merely marketing product. Product can be purchased from many retailers. Care and service cannot.
We have a great deal of control in how we are treated and how we are perceived in the healthcare marketplace. The decisions we make and the actions we take in 2021 could have a profound influence. The time is now to right the ship and change the perception of our profession. Accomplishing this though will take a concerted effort by a critical mass of audiologists! Are you onboard?
What are YOU willing to commit for audiology to
achieve long-term gains?
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