Coverage of audiology services under the Medicare program

(a) In general Section 1861(s)(2) of the Social Security Act (42 U.S.C. 1395x(s)(2)) is amended— (1) in subparagraph (JJ), by inserting and after the semicolon at the end; and (2) by adding at the end the following new subparagraph: (KK) audiology services (as defined in subsection (ll)(3));. (b) Improved access to audiology services Paragraph (3) of section 1861(ll) of the Social Security Act (42 U.S.C. 1395x(ll)) is amended to read as follows: (3) The term audiology services means such hearing and balance assessment services and, beginning January 1, 2027, such treatment services, furnished by a qualified audiologist which the qualified audiologist is legally authorized to perform under State law (or the regulatory mechanism provided by State law), as would otherwise be covered if furnished by a physician or as incident to a physician’s service. A qualified audiologist shall be permitted to furnish such audiology services without regard to any requirement that the individual receiving such audiology services is under the care of (or referred by) a physician or other health care practitioner or that such services are furnished under the supervision of a physician or other health care practitioner.. (c) Payment amount and coinsurance Section 1833(a)(1) of the Social Security Act (42 U.S.C. 1395l(a)(1)) is amended— (1) by striking and before (HH); and (2) by inserting the following before the semicolon: and (II) with respect to audiology services furnished under section 1861(s)(2)(KK), the amounts paid shall be 80 percent of the lesser of the actual charge for the services or the fee schedule amount provided under section 1848. (d) Payment on assignment-Related basis Section 1842(b)(18)(C) of the Social Security Act (42 U.S.C. 1395u(b)(18)(C)) is amended by adding at the end the following new clause: (ix) A qualified audiologist (as defined in section 1861(ll)(4)(B)).. (e) Inclusion of qualified audiologists as RHC and FQHC practitioners Section 1861(aa)(1)(B) of the Social Security Act (42 U.S.C. 1395x(aa)(1)(B)) is amended— (1) by striking or by a mental and inserting by a mental; and (2) by inserting or by a qualified audiologist (as defined in subsection (ll)(4)(B)), after (as defined in subsection (lll)(4)),. (f) Rule of construction Nothing in the amendments made by this section shall be construed to expand the scope of audiology services or services for which payment may be made to other providers under title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.) beyond those services for which such payment may be made as of December 31, 2026. (g) Effective date The amendments made by this section shall apply to items and services furnished on or after January 1, 2027.