UPDATED: 2022 MPFS Final Rule Summary for Audiologists

Jan 11, 2022 | Billing, Coding & Billing

Get a Complete Update on the 2022 Medicare Coding and Billing Changes

Can you confidently navigate the process to get everything you’re owed? Staying up-to-date with coding and billing standards is crucial to getting reimbursed in a timely manner for the audiology services that your practice provides. While coding errors can be resolved, the payment delays they cause can be detrimental to your business’s accounts receivable.

The bottom line: if you don’t code correctly, you won’t get paid for your services.


Summary of the Impact to Audiologists from the 2022 Medicare Physician Fee Schedule

On November 2, 2021, the Centers for Medicare and Medicaid Services published the final rule of the Medicare Physician Fee Schedule, updating payment and coding methodologies for 2022.

Below is a summary of the impact to audiologists for 2022.

Audiologists can expect to see an overall 2% reduction in payments, dependent on locality. This is welcome news, given the proposed rule suggested a much greater impact (possibly 10%).

The 2% sequestration rate instituted in 2011 and recently relaxed will be placed in effect and is expected to continue until 2030. This 2% rate reduction will be applied to individual claims.

The conversion factor, a component of the payment formula, was reduced from $34.89 in 2021 to $34.61 in 2022, a better outcome than what the proposed rule offered

There were no changes to current telehealth services after the Public Health Emergency (PHE). CMS has allowed some diagnostic testing to be performed via telehealth during the pandemic; after the PHE has been deemed expired, those services will no longer be recognized for payment by CMS for Part B beneficiaries when performed by an audiologist via telehealth. The PHE date has been extended several times in 90-day intervals and at the time of this writing, it was to end on January 16, 2022.

The Merit Incentive Payment System (MIPS) is still allowing for audiologists to report voluntarily under the low volume threshold methodology, but there are corporate entities employing audiologists where reporting may be required. To meet the low volume threshold, a provider bills less than $90,000 to Medicare AND performs 200 or fewer procedures AND sees 200 or fewer beneficiaries. Check here to ensure your participation status for 2022. Some related changes and details include:

  • Measure #154, Falls Risk Assessment, has been deleted for 2022
  • Measure #182, Functional Outcomes Assessment, can only be reported via electronic reporting (such as your office management system) and not on a claim
  • It is encouraged that audiologists report voluntarily in the Merit Incentive Payment System. There are additional measures that can only be reported via a registry, new for 2022. Healthmonix has the only dedicated audiology specific registry.

Part B beneficiary deductibles are $233 for 2022, an increase from $203 in 2021.

Several CPT© codes have been deleted due to low utilization:

  • 92560 Bekesy audiometry, screening
  • 92561 Bekesy audiometry, diagnostic
  • 92564 Short Increment Sensitivity Test
  • 92599 Audiometric testing of groups

Questions may be directed to Debbie Abel, AuD, Manager of Coding and Contracting, at [email protected].

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