OL302 - Positioning Audiology Practice for Limited Direct Access

The years-long effort to achieve direct access to audiology services has come to fruition. The proposal by CMS for limited direct access,which was adopted in its final rule, and the elimination of medical waiver requirements by the FDA and Congress have highlighted that audiologists are trained and licensed to evaluate, diagnose, and treat hearing conditions. Yet the nuances of what direct access means need to be understood by audiologists, including the significance of medical necessity. With direct access, it is no longer a physician determining the necessity of hearing evaluation and referral to the audiologists; instead, the audiologist is making the determination of the medical necessity for 36 of audiologic hearing evaluation and treatment procedures. Audiologists must provide documentation of medical necessity in the health care record. If the audiologist’s records are ever reviewed or audited by CMS for Medicare patients, those records need to support the medical necessity of every item and service provided. This session will discuss the status of limited direct access and the strategies for protecting your patients and your practice.