Medicare Claims Processing Manual (Pub. 100-04), Ch. 7 § 40.1
Audiologic Tests
40.1 - Audiologic Tests
(Rev. 980, Issued: 06-14-06, Effective: 10-01-06, Implementation: 10-02-06)
Audiologic tests will generally be billed to the carrier by the provider of service. For
tests that include both a professional component and technical component, the SNF may
elect to bill the technical component to the intermediary, but is not required to bill the
service. See Pub 100-02 chapter 15, section 80.3 for further information on audiology.
Payment to SNFs for audiologic tests are bundled into the PPS payment amount for
beneficiaries in a covered SNF Part A stay, whether provided directly by the SNF or
under arrangements by an independent provider based on a contract with the SNF.
Independent audiologists may bill the carrier directly for services rendered to
beneficiaries not in a SNF Part A covered stay. For beneficiaries not in a covered Part A
SNF stay, who are sometimes referred to as beneficiaries in a Part B SNF stay, audiologic
tests are payable under Part B when billed by the SNF as type of bill 22X, or when billed
directly to the carrier by the provider of the service. Payment is based on the Medicare
Physician Fee Schedule (MPFS), whether by the carrier or the intermediary.
Since audiologic tests are not bundled with speech -language pathology services,
payment is made to the provider of service or to the SNF where the services are provided
under arrangements with the SNF for SNF outpatients.