TMPPM 2010 > Children's Services Handbook > School Health and Related Services (SHARS) > Services/Benefits, Limitations, and Prior Authorization > Audiology

   
 

4.3.1 Audiology

Audiology and hearing aid services for clients with suspect or permanent hearing lost that were available through DSHS until September 1, 2009, that have been transitioned to Texas Medicaid may only be reimbursed to appropriately-enrolled audiologists and hearing aid providers, not SHARS providers.

Refer to: Subsection 2.2.3, "Audiology and Audiometry Evaluation and Diagnostic Services", and subsection 2.2.3.3, "SHARS Audiology Services" in the Vision and Hearing Services Handbook (Vol. 2, Provider Handbooks).

Audiology evaluation services include:

Identification of children with hearing loss

Determination of the range, nature, and degree of hearing loss, including the referral for medical or other professional attention for the habilitation of hearing

Determination of the child's need for group and individual amplification

Audiology therapy services include the provision of habilitation activities, such as language habilitation, auditory training, audiological maintenance, speech reading (lip reading), and speech conversation.

Audiology services must be provided by a professional who holds a valid state license as an audiologist or by an audiology assistant who is licensed by the state when the assistant is acting under the supervision of a qualified audiologist. State licensure requirements are equal to American Speech-Language-Hearing Association (ASHA) certification requirements.

Audiology evaluation is billable on an individual (92506) basis only. Audiology therapy is billable on an individual (92507) and group (92508) basis. Only the time spent with the student present is billable; time spent without the student present is not billable. Session notes for evaluations are not required; however, documentation must include the billable start time, billable stop time, and total billable minutes with a notation of the activity performed (e.g., audiology evaluation). Session notes are required for therapy. Session notes must include the billable start time, billable stop time, total billable minutes, activity performed during the session, student observation, and the related IEP objective.


Texas Medicaid & Healthcare Partnership
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