To be able to submit claims for audiology and audiometry evaluation and diagnostic services for suspected and confirmed hearing loss, audiologists employed by or contracted with school districts, state agencies, and inpatient hospitals should choose “Audiologist” on the enrollment application.
To be able to submit claims for hearing aid devices and accessories and fitting and dispensing visits and revisits, audiologists and hearing aid fitters and dispensers employed by or contracted with school districts, state agencies, and inpatient hospitals should choose “Hearing Aid” on the enrollment application.
Audiologists and hearing aid fitters and dispensers may enroll with Texas Medicaid and the CSHCN Services Program as follows:
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Audiologists |
Hearing Aid Providers (i.e., Fitters and Dispensers) |
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Individual practitioner: Audiologists who enroll as individuals will receive a unique provider identifier with which to file claims. |
Individual practitioner: Hearing aid fitters and dispensers who enroll as individuals will receive a unique provider identifier with which to file claims. |
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Group practitioner: Audiologists that enroll as a group receive a group provider identifier with which to file claims. Each individual provider within the group (i.e., the “performing providers” who will perform the services under the group provider identifier) must also enroll as part of the group. A group must submit at least one performing provider to be enrolled and added to the group after the group is enrolled. |
Facility: The hearing aid fitter and dispenser may also enroll as a facility and will receive a unique provider identifier with which to file claims for hearing devices. |
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Important: Providers who want to enroll as both an audiologist and a hearing aid provider must complete an application for each enrollment. |
Appropriately-licensed providers who want to provide both audiology services and hearing aid fitting and dispensing services must complete applications for audiologist and for hearing aid fitter and dispenser for each program for which they want to enroll.
Audiology evaluation and therapy services procedure codes 1-92506, 1-92507, and 1‑92508 may continue to be reimbursed to school districts and state agencies that are enrolled with Texas Medicaid as School Health and Related Services (SHARS) providers.
Audiology and hearing aid services that are available through PACT until September 1, 2009, are being transitioned to Texas Medicaid and the CSHCN Services Program. Effective for dates of service on or after September 1, 2009, these services may only be reimbursed to audiologists and hearing aid providers enrolled with Texas Medicaid and the CSHCN Services Program and not to SHARS providers.