S. 1996
119th CONGRESS 1st Session
To amend title XVIII of the Social Security Act to improve coverage of audiology services under the Medicare program, and for other purposes.
IN THE SENATE OF THE UNITED STATES · June 9, 2025 · Sponsor: Ms. Warren · Committee: Committee on Finance
Table of contents
SEC. 1. Short title
- This Act may be cited as the Medicare Audiology Access Improvement Act of 2025.
SEC. 2. Coverage of audiology services under the Medicare program
- (a) In general
- Section 1861(s)(2) of the Social Security Act () is amended— 42 U.S.C. 1395x(s)(2)
- in subparagraph (JJ), by inserting after the semicolon at the end;
and- audiology services (as defined in subsection (ll)(3));
- by adding at the end the following new subparagraph:
- in subparagraph (JJ), by inserting after the semicolon at the end;
- Section 1861(s)(2) of the Social Security Act () is amended— 42 U.S.C. 1395x(s)(2)
- (b) Improved access to audiology services
- Paragraph (3) of section 1861(ll) of the Social Security Act () is amended to read as follows: 42 U.S.C. 1395x(ll)
- The term
audiology servicesmeans such hearing and balance assessment services and, beginning January 1, 2027, such treatment services, furnished by a qualified audiologist which the qualified audiologist is legally authorized to perform under State law (or the regulatory mechanism provided by State law), as would otherwise be covered if furnished by a physician or as incident to a physician’s service. A qualified audiologist shall be permitted to furnish such audiology services without regard to any requirement that the individual receiving such audiology services is under the care of (or referred by) a physician or other health care practitioner or that such services are furnished under the supervision of a physician or other health care practitioner.
- The term
- Paragraph (3) of section 1861(ll) of the Social Security Act () is amended to read as follows: 42 U.S.C. 1395x(ll)
- (c) Payment amount and coinsurance
- Section 1833(a)(1) of the Social Security Act () is amended— 42 U.S.C. 1395l(a)(1)
- by striking before (HH);
and - by inserting the following before the semicolon: .
- by striking before (HH);
- Section 1833(a)(1) of the Social Security Act () is amended— 42 U.S.C. 1395l(a)(1)
- (d) Payment on assignment-Related basis
- Section 1842(b)(18)(C) of the Social Security Act () is amended by adding at the end the following new clause: 42 U.S.C. 1395u(b)(18)(C)
- (ix) A qualified audiologist (as defined in section 1861(ll)(4)(B)).
- Section 1842(b)(18)(C) of the Social Security Act () is amended by adding at the end the following new clause: 42 U.S.C. 1395u(b)(18)(C)
- (e) Inclusion of qualified audiologists as RHC and FQHC practitioners
- Section 1861(aa)(1)(B) of the Social Security Act () is amended— 42 U.S.C. 1395x(aa)(1)(B)
- by striking
or by a mentaland insertingby a mental; and - by inserting after .
- by striking
- Section 1861(aa)(1)(B) of the Social Security Act () is amended— 42 U.S.C. 1395x(aa)(1)(B)
- (f) Rule of construction
- Nothing in the amendments made by this section shall be construed to expand the scope of audiology services or services for which payment may be made to other providers under title XVIII of the Social Security Act () beyond those services for which such payment may be made as of December 31, 2026. 42 U.S.C. 1395 et seq.
- (g) Effective date
- The amendments made by this section shall apply to items and services furnished on or after January 1, 2027.