New and Revised CPT Codes For 2018

Audiology

The following are new modifiers of interest to audiologists, effective January 1, 2018. No major changes to CPT codes related to hearing and vestibular services will take effect in 2018.

New CPT Codes

No new audiology codes have been added for 2018.

Revised CPT Codes

No audiology codes have been revised for 2018.

Deleted CPT Codes

No audiology codes have been deleted for 2018.

Other Changes

New CPT Code Modifiers

The following new CPT code modifiers can be used to delineate whether a service is habilitative or rehabilitative in nature.

Modifier 96 (Habilitative services)
When a service or procedure that may be either habilitative or rehabilitative in nature is provided for habilitative purposes, the physician or other qualified health care professional may add modifier 96 to the service or procedure code to indicate that the service or procedure provided was a habilitative service. Habilitative services help an individual learn skills and functioning for daily living that the individual has not yet developed, and then keep and/or improve those learned skills. Habilitative services also help an individual keep, learn, or improve skills and functioning for daily living.

Modifier 97 (Rehabilitative services)
When a service or procedure that may be either habilitative or rehabilitative in nature is provided for rehabilitative purposes, the physician or other qualified health care professional may add modifier 97 to the service or procedure code to indicate that the service or procedure provided was a rehabilitative service. Rehabilitative services help an individual keep, get back, or improve skills and functioning for daily living that have been lost or impaired because the individual was sick, hurt, or disabled.

ASHA NOTES:
  • Affordable Care Act (ACA) compliant plans may use these new modifiers to track habilitative and rehabilitative benefits.
  • These new modifiers will not replace existing modifier SZ (habilitative services).
  • Check with your payers regarding implementation of the new modifiers.

See also:

ASHA Corporate Partners