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
- Additional Details on 2023 Medicare Fee Schedule, Including Payment Cuts, Access to Audiology Services (11/11/2022)
- 2023 Medicare Part B Final Rule Released (11/2/2022)
- Federal Public Health Emergency Updates for 2022 (10/13/2022)
- Take Action! The payment cuts have been partially mitigated for 2022, but they're set to return in 2023. Contact your members of Congress to ask them to address the cuts again. See ASHA’s update page to get the latest news and learn more about ASHA’s ongoing advocacy efforts.
- Please continue to monitor this site or sign up for ASHA Headlines for important Medicare updates.
Get all the latest policy and payment 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 2023 MPFS
ASHA's analysis of the 2023 MPFS provides an overview of relevant policy changes and calculates national average payment amounts for audiologists and SLPs, including a comparison with 2022 payment rates to help clinicians estimate the impact of the Medicare cuts.
- New! 2023 Medicare Fee Schedule for Audiologists [PDF]
- New! 2023 Medicare Fee Schedule for Speech-Language Pathologists [PDF]
Analysis of the 2022 MPFS
- 2022 Medicare Fee Schedule for Audiologists [PDF]
- 2022 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.
- 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]
