Definitions

The following terms used in 130 CMR 426.000 have the meanings given in 130 CMR 426.402 unless the context clearly requires a different meaning. The reimbursability of services defined in 130 CMR 426.402 is not determined by these definitions, but by application of regulations elsewhere in 130 CMR 426.000 and 450.000: Administrative and Billing Regulations. Accessories — those essential items or options on a hearing aid, purchased by an audiologist that are not intrinsic components of the basic hearing-aid unit. Accessories do not include nonessential items such as carrying cases. Adjusted Acquisition Cost — the unit price paid to a manufacturer by an audiologist for a hearing aid or accessories, excluding postal-insurance charges. The adjusted acquisition cost does not exceed the manufacturer's current catalog price and is verified by a copy of the manufacturer's invoice retained by the audiologist in the member's medical record as described under 130 CMR 426.419. Audiological Services — these services include, but are not limited to, testing related to the determination of hearing loss, evaluation for hearing aids, prescription for hearing-aid devices, and aural rehabilitation. Auditory Training — the training of the auditory modality to improve understanding of the speech or language of other speakers. Auditory training is one of the components of aural rehabilitation. Aural Rehabilitation — therapy, including, but not limited to, speech reading and auditory training, provided by a licensed certified audiologist either in a group or individually. Binaural — the type of fitting or hearing aid necessitated by varying degrees of hearing loss in both ears that requires unparalleled amplification via the use of two microphones and two receivers. Binaural Fitting — the fitting of two hearing aids, one to each ear, by the audiologist; the fitting to the second ear taking place no later than six months after the fitting to the first ear. Complete Audiological Evaluation — an evaluation that includes a routine audiological examination (air and bone conduction, spondee thresholds, and word discrimination testing) as recommended by a physician. Date of Service — the date on which the medical service is furnished to a member or, in the case of custom-made goods, the date on which the goods are delivered to a member. Dispense — the prescription of a hearing aid, its modification, its fitting, orientation to its use, and any adjustments required within the manufacturer's trial warranty period. Dispensing Fee — a one-time-only fee for dispensing monaural or binaural hearing aids. The fee includes initial programming, fitting, orientation to its use, and any adjustments required during the manufacturer’s trial warranty period. Group Session — therapeutic services directed by the audiologist toward more than one patient in a single encounter, using group participation as a treatment technique. Hearing Aid — a hearing aid is a small electronic device consisting of a microphone, amplifier and a receiver. Hearing-Aid Evaluation — a procedure conducted by an audiologist that may include an assessment of the member's response to appropriate tests (real ear measurements or functional gain measurements). Impedance — an evaluation that includes tympanometry, stapedial acoustic reflex testing, and acoustic reflex decay. Independent Audiologist — an audiologist who is licensed in accordance with 130 CMR 426.404 and who is engaged in the practice of audiology through a private practice or self-employment, or both. Major Repair — a repair to a hearing aid that must be made at a repair facility other than the audiologist's place of business. Minor Repair — a repair to a hearing aid performed at the audiologist's place of business, such as, but not limited to, the replacement or cleaning of tubing. Monaural Fitting — the fitting of one hearing aid by an audiologist. Out-of-Office Visit — treatment provided in a nursing facility or at the member's residence rather than at the audiologist's usual place of business. Speech Reading — the training of the visual modality to improve the understanding of the speech or language of other speakers. Speech reading is one of the components of aural rehabilitation.