Telemedicine and Your Practice-What Audiologists Need to Know

Author: Kim Cavitt, Au.D.

The U.S. Food and Drug Administration recently approved a remote feature for follow-up programming sessions for the Nucleus Cochlear Implant System. Also, both GN Resound and Signia have hearing aids which have the capacity to be reprogrammed or adjusted remotely. So, what do these technologic advances mean for audiologists? Can audiologists provide these services to their patients remotely? Can audiologists receive third-party reimbursement for the provision of these services?

If an audiologist is programming a cochlear implant or hearing aid remotely and the patient is not physically in their office, the audiologist is providing telemedicine/telehealth/telepractice. The provision and coverage of telemedicine is influenced by the following:
  • State and federal regulations pertaining to telemedicine, including but not limited to, state licensure, interstate practice compacts (which allow an audiologist to treat a patient who is physically in another state) and the Health Insurance Portability and Accountability Act of 2003 (HIPAA) Security provisions;
  • How your malpractice liability vendor addresses telemedicine and its provision of care; and
  • Whether or not your contracted third-party payers provide coverage for audiology telemedicine services.
Medicare does not cover telemedicine provided by an audiologist. So, in this case, 92602 and 92604 (subsequent reprogramming of a cochlear implant) will not be covered by Medicare if provided via telemedicine. If allowed by state licensure in both the audiologist’s and the patient’s state, and allowed by the audiologist’s malpractice provider, the patient would be responsible for the cost of these cochlear implant procedures.

Prior to beginning a telemedicine program, the following considerations are recommended:
  • DO NOT blindly follow manufacturer guidance on this issue.
  • DO NOT immediately assume an audiologist can provide these services in your state.
  • Contact your state licensure board, in writing, to determine if:
    • Telemedicine can be provided by audiologists and/or hearing aid dispensers.
    • An audiologist can see a patient who is housed in another state on the date of the visit.
  • Contact your malpractice insurance vendor to determine their coverage of telemedicine.
  • The audiologist may need a separate policy or policy rider for telemedicine.
  • Review your third-party payer guidance (contracts, provider manuals, medical policies, or administrative guidelines) to determine if third-party coverage is available for telemedicine provide by an audiologist.
  • Contact an IT consultant to ensure that the practice systems meet the HIPAA security guidelines for telemedicine and/or the transmission of electronic protected health information (ePHI).
  • Determine how the practice intends on receiving payment from the patient for the provision of non-covered services provided via telemedicine.
Here are some available resources to review and consider before providing telemedicine: For questions, please contact Kim Cavitt, AuD at kim.cavitt@audiologyresources.com or 773-960-6625.    
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.