Remote Hearing Aid Evaluation, Fitting and Management by Audiologists

Author: Kim Cavitt, Au.D.

We are in the midst of a national health crisis and most audiologists have closed their clinics in an attempt to follow professional, state and federal guidance. We now expect to be home for the entire month of April, at the very least.

So, what hearing aid related items and services can we provide via telehealth? For some, many services are available. For others, no services are available. It is extremely dependent on state audiology and hearing aid dispenser licensure laws and consumer protection and telehealth regulations. It is also influenced by any executive or emergency orders or proclamations from the governors of your states.

A few general rules of thumb: Audiologists can only provide telehealth to individuals who are currently residing in the state(s) in which the audiologist is currently licensed to dispense hearing aids, either their audiology and/or hearing aid dispensing licensure. Medicare does not cover any audiology procedures or services provided by an audiologist via telehealth. As a result, all testing and evaluation would be private pay. Finally, you cannot bill a patient for telehealth services that you do not charge for in face to face interaction OR you have bundled into your current hearing aid delivery.

Please view this guidance for more detailed considerations and codes. In determining what can be provided via telehealth, you need to find answers to all of the following questions:
General Questions
  1. Is telehealth allowed in your state? Click here to learn more. There are still some states where telehealth is not allowed.
  2. Does your current malpractice and business insurance cover care provided via telehealth?
  3. Do your payers or third-party administrators/networks IN YOUR STATE allow for coverage of hearing aids and related services delivered by drop-off/mail and fit by telehealth?
  4. Who, in your patient population, would you be legally allowed and/or comfortable evaluating, fitting and managing via drop off/mail and fit by telehealth?
    1. Loss and damage replacements?
    2. Existing users?
    3. Pediatrics?
    4. New users?
    5. Private pay?
    6. Managed Care?
  5. Do patients, in your state, have to complete some form of telehealth acknowledgment or authorization form?
    1. If yes, how will you get this signed form forwarded to you?
Evaluation Questions
  1. Does your state have requirements as to what constitutes an audiogram (in order to fit hearing aid in your state)?
    1. Can you meet those requirements via telehealth or via an online or app evaluation?
  2. Does your state have test environment requirements for hearing testing?
    1. Can you meet those requirements via telehealth?
  3. Does your state have requirements as to the age of the audiogram?
  4. Has the patient already received a compliant audiogram within the age requirement?
  5. What type and level of testing can you provide via telehealth OR via an online or app option?
  6. For those who typically charge for this visit, how do you monetize and collect payment for this visit?
Communication Needs Assessments or Hearing Aid Examination and Selection
  1. Are you a bundled or unbundled hearing aid delivery? You cannot charge someone for a service via telehealth that you would not charge them for in a face to face delivery.
  2. Has this service already been provided?
  3. What type and level of this service can you provide via telehealth?
  4. How will you get state required medical clearances or medical waivers signed and forwarded to you?
  5. For those who typically charge for this visit, how do you monetize and collect payment for this visit?
Hearing Aid Fitting
  1. Are you a bundled or unbundled hearing aid delivery? You cannot charge someone for a service via telehealth that you would not charge them for in a face to face delivery.
  2. Does your state have requirements as to what must be included in a hearing aid fitting?
    1. Do these requirements have to met at fitting or can it be met in follow-up visits (at a later date)?
    2. Can these requirements be met via telehealth?
  3. Have the aids already been ordered? Are they sitting on your shelf?
  4. Will they be pre-programmed by you or the manufacturer?
  5. How will you get the aids to the patient?
  6. What type and level of this service can you provide via telehealth?
  7. How do you get the state required bill of sale/hearing aid receipt signed and forwarded to you?
  8. How do you monetize and collect payment for this visit?
  9. Can this be billed to and covered by a third-party?
Hearing Aid Follow-up
  1. Are you a bundled or unbundled hearing aid delivery? You cannot charge someone for a service via telehealth that you would not charge them for in a face to face delivery.
  2. What type and level of this service can you provide via telehealth?
  3. How will you handle returns for credit? Exchanges?
  4. For those who typically charge for this visit, how do you monetize and collect payment for this visit?
I firmly believe that remote evaluation, hearing aid fitting and management may be a viable option for some patients over the coming months. I recommend folks explore these options if they are looking for a potential revenue stream.

If ADA members have further questions or would like to learn more, please contact Kim Cavitt at kim.cavitt@audiologyresources.com or 773-960-6625 (text or call).    
Dr. Kim Cavitt was a clinical audiologist and preceptor at The Ohio State University and Northwestern University for the first ten years of her career. Since 2001, Dr. Cavitt has operated her own Audiology consulting firm, Audiology Resources, Inc. She currently serves on the State of Illinois Speech Pathology and Audiology Licensure Board. She also serves on committees through AAA and ASHA and is an Adjunct Lecturer at Northwestern University.