One of the hottest topics in the current coding and reimbursement arena is whether to bundle or unbundle hearing aid and/or assistive listening device services. When services are bundled, the price of the hearing aid(s) as well as the fees to deliver and provide follow-up services for the device(s) are combined into one inclusive fee. When fees are itemized or unbundled, the price of the hearing aid(s) as well as the fees to deliver the hearing aid(s) are billed and itemized separately. Incidentally, when the hearing aid claim is filed to a third-party payor, reimbursement is more likely to be captured when services are itemized, however, many practitioners feel itemized services may result in patients not returning to their office for the necessary follow-up care. Interestingly, the Hearing Loss Association of America, in their April 2011 Support HLAA’s Campaign to Make Hearing Aids Affordable initiative, “believes unbundled hearing aids along with cost transparency is the model that most benefits consumers with hearing loss”.
In 2010, the American Academy of Audiology conducted a member survey, querying members about their hearing aid billing practices. The survey revealed that 39% of audiologists provided professional services into the price of a hearing aid and 34% included professional services for the duration of the warranty period only. Coincidentally, there are increasing numbers of third-party insurance plans which are including hearing aids as a “benefit.” How those payors categorize hearing aids determines your reimbursement as well as the patient’s personal fiscal responsibility; itemizing all of your fees is more likely to result in third-party payor reimbursement for the price of the device and related professional fees.
There are a variety of resources available to audiologists on this topic. For example, unbundling was the inaugural topic for last month’s American Academy of Audiology’s Coding and Reimbursement series, featuring co-presenter Stephanie Sjoblad, Au.D, who for the last two years, has discussed this topic in detail at AudiologyNOW! Members of the Academy can view Dr. Sjoblad’s Unbundling and Itemized Hearing Aid Services seminar via the Academy’s eAudiology continuing education center. To assist in billing efforts, Academy members may also access a new Audiology Superbill Template, a form listing all the HCPCS codes utilized for hearing aids, supplies, and some procedures provided by the American Academy of Audiology. If you are not an Academy member, the HCPCS codes may be accessed from the Centers for Medicare and Medicaid Services website by selecting 2011 Alpha-Numeric HCPCS File that is available for download. Also, be sure to check out the Frequently Asked Questions about coding on the Academy’s website for general billing information related to various audiology procedures.
This blog post was contributed by Dr. Debbie Abel, an audiologist and Director of Reimbursement and Practice Compliance for the American Academy of Audiology. She is past Chair of the Academy’s Coding and Reimbursement Committee and past member of the AAA Governmental Affairs Committee, the AAA Ethical Practices Board, past President of the Ohio Academy of Audiology, and past Chair and Vice Chair of the Ohio Board of Speech-Language Pathology and Audiology. For more information and answers to your questions about coding and reimbursement, please contact Dr. Abel at firstname.lastname@example.org.