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Melissa Posted Fri 20th of October, 2017 10:13:32 AM
I want to make sure I understand this correctly: Audiologists are required to enroll in Medicare as either participating or non-participating; If the Audiologist is an employee of a Physician, the audiologist must bill his/her services under their own NPI number and cannot bill under the NPI number of the Physician. If I am understanding this correctly, do we bill separate claims for an office visit by the Physician and audiology services by the Audiologist?
SuperCoder Answered Mon 23rd of October, 2017 09:11:39 AM

Hi Melissa,

For audiologists who are enrolled and bill independently for services they render, the audiologist’s NPI is required on all claims they submit. For example, in offices and private practice settings, an enrolled audiologist shall use his or her own NPI in the rendering loop to bill under the MPFS for the services the audiologist furnished. If an enrolled audiologist furnishing services to hospital outpatients reassigns his/her benefits to the hospital, the hospital may bill the Medicare contractor for the professional services of the audiologist under the MPFS using the NPI of the audiologist. If an audiologist is employed by a hospital but is not enrolled in Medicare, the only payment for a hospital outpatient audiology service that can be made is the payment to the hospital for its facility services under the hospital Outpatient Prospective Payment System (OPPS) or other applicable hospital payment system.

Audiology services are diagnostic tests, when furnished in an office or hospital outpatient department, they must be furnished by or under the appropriate level of supervision of a physician. Thank you.

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