Medicare Payment for Outpatient Audiology and Speech-Language Pathology Services

The Medicare Physician Fee Schedule and Hospital Outpatient Prospective Payment System

ASHA provides information on payment for audiology and speech-language pathology Medicare services provided in all outpatient settings, including in-depth analysis of relevant policy changes and national payment rates.

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News and Updates

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The Medicare Physician Fee Schedule (MPFS)

Audiology and speech-language pathology services under Medicare Part B (outpatient) have reimbursement rates established by the MPFS regardless of provider setting, except for outpatient audiology services provided in hospitals. ASHA provides information on the MPFS for audiologists and SLPs, including in-depth analysis of relevant policy changes and revisions to the fee schedule, Medicare Part B payment rules, geographic adjustment calculations, and new developments each calendar year. The Centers for Medicare & Medicaid Services (CMS) updates the fee schedule annually for implementation on January 1.

Analysis of the 2024 MPFS

ASHA's analysis of the 2024 MPFS provides an overview of relevant policy changes and calculates national average payment amounts for audiologists and SLPs, including a comparison with 2023 payment rates to help clinicians estimate the impact of the Medicare cuts.

Take Action! The payment cuts are set to return in 2024. Contact your members of Congress to ask them to improve Medicare payment rates.

Analysis of the 2023 MPFS

Understanding the Medicare Fee Schedule

The Hospital Outpatient Prospective Payment System (OPPS)

Medicare pays for hospital-based outpatient audiology services under the OPPS. Speech-language pathology services performed in hospital outpatient clinics are billed fee-for-service through the MPFS, with the exception of a few CPT codes not classified as “always” or “sometimes” therapy codes. CMS updates the OPPS annually for implementation on January 1. For information on 2024 upcates, see Medicare Finalizes Payment Updates for Outpatient Hospital Departments for 2024.

Understanding the OPPS

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