Sponsors (11)
Read twice and referred to the Committee on Finance.
Last progress June 9, 2025 (8 months ago)
Introduced on June 9, 2025 by Elizabeth Warren
Adds audiology services to Medicare coverage and defines what those services include. The law lets qualified audiologists furnish audiology services and, beginning January 1, 2027, provide certain treatment services without a physician referral or physician supervision, and directs changes to Medicare payment and program rules to support this coverage.
Amends section 1861(s)(2) of the Social Security Act by adding a new subparagraph (KK) that lists "audiology services (as defined in subsection (ll)(3))" as a covered item.
Amends paragraph (3) of section 1861(ll) to define "audiology services" as hearing and balance assessment services and, beginning January 1, 2027, treatment services, when furnished by a qualified audiologist legally authorized under State law.
Permits a qualified audiologist to furnish the defined audiology services without regard to any requirement that the recipient be under the care of (or referred by) a physician or that services be furnished under physician supervision.
Amends section 1833(a)(1) of the Social Security Act related to payment amount and coinsurance; the excerpt shows textual edits are made but the specific inserted text is not shown in this excerpt.
Adds a new clause (ix) to section 1842(b)(18)(C) to include a "qualified audiologist (as defined in section 1861(ll)(4)(B))" for purposes of payment on an assignment-related basis.
Medicare beneficiaries (particularly older adults and people with hearing loss) will likely see easier access to audiology services because they can obtain care from qualified audiologists without a physician referral or supervision. Qualified audiologists benefit by gaining clearer authority to provide and bill for audiology and certain treatment services, which may expand their scope of practice and revenue streams. Physicians may see reduced administrative referrals for routine audiology care. CMS will need to update benefit policy, billing/coding guidance, and payment systems, and the Medicare program may experience increased utilization and corresponding spending depending on demand. State scope-of-practice rules and existing professional credentialing may affect how audiologists qualify to furnish and bill under Medicare; CMS implementation guidance will determine the operational details and any limits tied to qualifications, documentation, or payment rates.
Updated 4 days ago
Last progress April 9, 2025 (10 months ago)