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.
On this page:
- News and Updates
- The Medicare Physician Fee Schedule
- The Hospital Outpatient Prospective Payment System
News and Updates
- Update: ASHA's analysis of the 2022 Medicare Physician Fee Schedule has been updated with the new payment rates. (December 27, 2021)
- Update: ASHA's analysis of the 2022 Hospital Outpatient Prospective Payment System is now available. (December 14, 2021)
- Take Action! The payment cuts have been partially mitigated. Contact your members of Congress to ask them to fully address the cuts. Please see ASHA’s update page to get the latest news and learn more about ASHA’s ongoing advocacy efforts.
- News: ASHA Continues Fight to Stop Medicare Cuts (December 13, 2021)
- News: Now Available: ASHA's Analysis of 2022 Medicare Fee Schedule for Audiologists and Speech-Language Pathologists (November 17, 2021)
- Please continue to monitor this site or sign up for ASHA Headlines for important Medicare updates.
Get all the latest billing and reimbursement news.
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 2022 MPFS
(Updated 12/27/2021)
ASHA's analysis of the 2022 MPFS provides an overview of relevant policy changes and calculates national average payment amounts for audiologists and SLPs, including a comparison with 2021 payment rates to help clinicians estimate the impact of the Medicare cuts. On December 10, 2021, Congress intervened to partially mitigate the cuts. ASHA provides the updated payment rates below.
- Updated! 2022 Medicare Fee Schedule for Audiologists [PDF]
- Updated! 2022 Medicare Fee Schedule for Speech-Language Pathologists [PDF]
Analysis of the 2021 MPFS
- 2021 Medicare Fee Schedule for Audiologists [PDF]
- 2021 Medicare Fee Schedule for Speech-Language Pathologists [PDF]
Understanding the Medicare Fee Schedule
- Overview of the Medicare Physician Fee Schedule
- Calculating Medicare Fee Schedule Rates
- The Medicare Quality Payment Program
- Audiology Payment Rules
- Speech-Language Pathology Payment Rules
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. ASHA provides information on the OPPS for audiologists and SLPs, including an analysis of relevant policies, changes to Ambulatory Payment Classifications (APCs), and rates for implementation each calendar year. CMS updates the OPPS annually for implementation on January 1.
Analysis of the OPPS
ASHA's analysis of the OPPS provides an overview of relevant policy changes and national APC payment amounts for audiologists and SLPs.
- New! 2022 Hospital Outpatient Prospective Payment System for Audiologists and Speech-Language Pathologists [PDF]
- 2021 Hospital Outpatient Prospective Payment System for Audiologists and Speech-Language Pathologists [PDF]
