Medicare Audiology Access Improvement Act of 2025
Summary
What This Bill Does
The Medicare Audiology Access Improvement Act changes how Medicare treats audiologists. Beginning January 1, 2027, Medicare would cover audiology diagnostic or treatment services that a qualified audiologist is legally authorized to perform under state law and that otherwise would be covered if furnished by a physician or incident to a physician service. The bill removes the requirement that the beneficiary be under physician care, referred by a physician or practitioner, or supervised by a physician or practitioner. Payment is set at 80 percent of the lesser of the actual charge or the physician fee schedule amount, and audiologists are added to Medicare assignment rules. The bill preserves existing scope limits by saying it does not expand services beyond those payable as of December 31, 2026.
Who Benefits and How
Medicare beneficiaries needing hearing care benefit because they can access covered audiology services directly from qualified audiologists. Qualified audiologists benefit because they gain clearer Medicare billing authority for covered diagnostic and treatment services. Rural Medicare patients benefit if direct access reduces delays caused by physician referral or supervision requirements. Hearing-loss advocacy organizations benefit from a statutory Medicare pathway for audiology services.
Who Bears the Burden and How
CMS Medicare payment staff must update coverage, billing, assignment, and contractor instructions for audiology services. Medicare Administrative Contractors must process additional audiologist claims under the physician fee schedule methodology. Physician practices may lose some referral-control leverage over hearing and balance care. Medicare Part B financing bears costs for directly furnished audiology services that qualify for payment.
Key Provisions
- Adds audiology services to Medicare's covered medical and other health services category.
- Expands direct access by allowing qualified audiologists to furnish covered services without physician referral, care, or supervision requirements.
- Provides Medicare payment at 80 percent of the lesser of the actual charge or physician fee schedule amount.
- Establishes January 1, 2027 as the effective date for covered items and services.
Evidence Chain:
This summary is generated from the full bill text using AI analysis. Expand "Detailed Analysis" below for identified beneficiaries/burden bearers with clause-level evidence links.
At a Glance
What This Bill Does
Adds Medicare coverage for audiology diagnostic and treatment services furnished by qualified audiologists beginning January 1, 2027, without a physician referral or supervision requirement.
Key Policy Areas
Health Care, Medicare, Hearing Care
Primary Purpose
Adds Medicare coverage for audiology diagnostic and treatment services furnished by qualified audiologists beginning January 1, 2027, without a physician referral or supervision requirement.
Policy Domains
Resolution provisions
Identified Gains
- Medicare beneficiaries needing hearing care
- Qualified audiologists
- Rural Medicare patients
- Hearing-loss advocacy organizations
Identified Costs
- CMS Medicare payment staff
- Medicare Administrative Contractors
- Physician practices
- Medicare Part B financing
Sponsors
Legislative Progress
In CommitteeMr. Bilirakis (for himself, Mr. Mullin, Mr. Moran, and Mr. …
Referred to the Committee on Energy and Commerce, and in …
Introduced in House
Stakeholder Effects
cui bono?How this legislation distributes effects. Mention counts reflect frequency, not effect magnitude.
Medicare beneficiaries needing hearing care, Physician practices, Qualified audiologists
Positive-direction: Qualified audiologists
Negative-direction: Physician practices
CMS Medicare payment staff, Medicare Part B financing
Bill Structure & Actor Mappings
Who is "The Secretary" in each section?
We use a combination of our own taxonomy and classification in addition to large language models to assess meaning and potential beneficiaries. High confidence means strong textual evidence. Always verify with the original bill text.
Learn more about our methodology