Eli's Rehab Report

CMS spells out the 'impairments of the auditory system' umbrella

Your Medicare contractors may have often had trouble justifying reimbursement for aural rehabilitation -- until now. CMS transmittal 88 (CR 5921), released May 7, mostly contains information on recertifications and personnel requirements for therapists, but it also contains a section that better defines aural rehab.

The revised section (230.3 D 3) is titled "Impairments of the Auditory System." "It used to be titled just 'Aural Rehabilitation,' but now CMS has made it more detailed so that people will know what that encompasses," says Mark Kander, director of healthcare regulatory analysis for the American Speech-Language-Hearing Association. "This is good news for speech-language pathologists and audiologists."

CMS has declared that the terms "aural rehabilitation, auditory rehabilitation, auditory processing, lipreading and speech reading" are valid terms to describe "covered services related to perception and comprehension of sound through the auditory system" (emphasis added). The agency goes further to say that both auditory processing evaluations and treatments "may be covered and medically necessary."

The kicker: CMS recognizes both the SLP and the audiologist in evaluating patients for auditory system disorders but clearly states that "only speech-language pathologists may provide treatment."

Note: To read the full text, scroll to page 49 of the PDF file at http://www.cms.hhs.gov/Transmittals/downloads/R88BP.pdf.