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Auditory rehabilitation evaluation code payment increased

Rehab Private Practice Alert, January 11, 2006

The Centers for Medicare & Medicaid Services (CMS) recently released Transmittal 798, which contains emergency updates to the 2006 Medicare Physician Fee Schedule.

The new transmittal dramatically increases payment for CPT code 92626 (evaluation of auditory rehabilitation (AR) status; first hour) from a national rate of $22.07 to $81.76. The updated value for 92626 includes a revised non-facility practice expense relative value unit (RVU) of 2.20, over the originally published RVU of 0.55.

The timely revision of the 92626 rate is due to the American Speech-Language-Hearing Association's (ASHA) actions in working with CMS to explain the error contained in the final rule of November's Medicare fee schedule.

ASHA provided similar procedures (in terms of time and effort) for CMS to use for a crosswalk to a more appropriate valuation. The add-on 15 minute AR evaluation code (92627) now has a slightly decreased rate of $20.62, down from $22.07 because of a decrease in the malpractice expense RVU. You can find CMS Transmittal 798 on the CMS Web site at www.cms.hhs.gov.

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