If you are willing to pay for audiology services out of pocket, self-referral is possible. There’s no need to see a doctor to get a referral if you are not going to avail any insurance benefits. However, if you are going to avail insurance for an audiologist consultation, a referral is needed.
Currently, all diagnostic audiological procedures covered by Medicare need a physician referral, with the main requirement influencing reimbursement being the purpose of testing. Medicare covers procedures that are medically necessary and appropriate for a patient’s treatment and diagnosis. The physician must write in the medical record the specific sign, symptom, or complaint that necessitates the service for each treatment charged.
A hearing instrument specialist is state-licensed hearing health professional trained to evaluate common types of hearing loss in adults and fit hearing aids. Audiologists are the primary health-care doctors who evaluate, diagnose, treat, and manage hearing loss and balance disorders in individuals of all ages from infants to adults and the elderly. Audiologists are also versed in fitting and fine tuning hearing technologies including hearing aids and surgically implanted devices.
Hearing aid dispensers (HADs) are fully qualified professionals who assess hearing and provide hearing aid aftercare. To employ hearing technology, hearing aid dispensers must be qualified and apply for a license. Audiologists can evaluate and diagnose a broader spectrum of hearing and balance issues. An audiologist is better suited for providing services related to balance problems, earwax impactions, and noise-induced hearing loss. Hearing aid maintenance, cleaning, repairs, and fitting adjustments can be performed by either specialist.