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Audiologists Resuming Services During COVID-19

Many audiology services can’t quickly pivot to telepractice, which may result in audiologists experiencing a greater sense of urgency to return to or increase in-person services. ASHA is advocating for the expansion of codes that can be used for telepractice, as currently, the Centers for Medicare and Medicaid Services (CMS) have only approved only cochlear implant codes. Audiologists should check their private payer contracts to determine what codes/procedures are covered for telepractice provision. Audiologists face challenges related to reimbursement needs from in-person service provision and modification of services to allow for their personal safety and the safety of those with whom they work. 

Considerations Related to Audiological Service Provision

Note: This list is not intended to be exhaustive and will be updated as additional information and opinions become available.

  • Use disposable items for each patient interaction. For example, speculum, inserts for audiometry, electrodes, immittance tips, and/or ear light tip
  • Consider requiring the use of masks for clients/patients, staff, and providers, or use plexiglass barriers. Also consider the use of clear, full-face plastic masks for providers.
  • Change the foam covering or barrier over microphones that audiologists use or consider providing each audiologist with their own headset mic that only they use.
  • Consider the use of video-otoscopy or other otoscopy technology that allows for adequate light and ability to view the ear, ear canal, and tympanic membrane while allowing physical distancing from the client/patient during otoscopic inspection.
  • Require patients to wear masks for earmold impressions, placement of tiptrodes, or other procedures that may elicit a cough reflex from the client/patient, as well as Video Head Impulse Test (vHIT) or head-shake tests with Frenzel goggles.
  • Wear PPE for procedures that involve close physical contact with patients, or delay performing such procedures, when possible (e.g., otoscopy, videonystagmography [VNG], electronystagmography [ENG]). 

Resources for Audiology Infection Control and Service Provision

COVID-19 Return-to-Work Guidance and Recommendations for Vestibular Clinicians

National Hearing Conservation Association (NHCA) – Best Practices Guidelines for Safely Conducting Hearing Testing During the COVID-19 Pandemic  [PDF]

CDC Infection Control Guidance for Healthcare Professionals About Coronavirus (COVID-19)

CDC Miscellaneous Activating Agents

A.U. Bankaitis’s Audiology Blog – Infection Control Anxiety: Acceptable Alternatives to Critical Supplies

American Academy of Audiology – Re-Opening in a Post-COVID World

NHCA – Best Practices Guidelines for Safely Conducting Hearing Testing During the COVID-19 Pandemic  [PDF]

State-by-State Tracking of Laws and Regulations for Telepractice and Licensure Policy [PDF]

Commercial Insurance Telepractice Policy Tracking [PDF]

Medicaid Telepractice Policy and State Emergency Order Tracking [PDF]

State-by-State Tracking of Laws and Regulations for Telepractice and Licensure Policy [PDF] 

E3 Tele-Acoustics – Guidelines for Maintaining a Clean Audio Testing Booth

“E3 Tele-Acoustics has had several inquiries from practices and clinics that are preparing to reopen after a period of closer due to the coronavirus. They were asking about the most appropriate and effective method for cleansing the air and surfaces inside the audiology test booth. We have discussed this with the manufacturer, and these are our recommendations: First ensure that the ventilation fans are running. Then allow 15 minutes in-between patients entering the booth in order to allow for a complete air exchange to take place. Clean and disinfect all the surfaces with which the patient will come in contact by using an appropriate disinfectant. This should include the door handles, chair, audiometer headset, bone vibrator, hand switch, and all other common surfaces. This procedure should also take place in-between each patient. In addition, please continue to monitor and follow all the CDC recommendations and guidelines to help protect vulnerable patients.”

Other Resources

CMS Re-Opening Facilities to Provide Non-Emergent Non-COVID-19 Healthcare: Phase I [PDF]

CMS Press Release: CMS Issues Recommendations to Re-Open Health Care Systems in Areas With Low Incidence of COVID-19  

The White House – Guidelines: Opening Up America Again

American Industrial Hygiene Association (AIHA) – Reopening Guidance for General Office Settings  [PDF]

ASHA Audiology Town Hall

Academy of Doctors of Audiology (ADA) Town Hall

ADA – COVID-19 and Employment Law


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