S1996119th CongressWALLET

Medicare Audiology Access Improvement Act of 2025

Sponsored By: Senator Elizabeth Warren

Introduced

Summary

Expanded Medicare coverage for audiology services. This bill would add audiology to Medicare's list of covered services and let qualified audiologists provide diagnostic and treatment care without needing a physician referral or supervision.

Show full summary
  • Medicare beneficiaries would gain more direct access to hearing and balance assessments and, beginning January 1, 2027, treatment services that Medicare would cover.
  • Qualified audiologists would be able to bill Medicare directly, participate in assignment, and receive payment as if the service were furnished by a physician or as an incident to a physician's service. Medicare would pay 80 percent of the lesser of the actual charge or the fee schedule amount.
  • Rural Health Clinics and Federally Qualified Health Centers would be able to include qualified audiologists as eligible practitioners, expanding where patients can get covered audiology care.

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Bill Overview

Analyzed Economic Effects

3 provisions identified: 2 benefits, 1 costs, 0 mixed.

More Medicare audiology coverage

If enacted, Medicare would add audiology services as a covered benefit. Hearing and balance assessments would be covered. Starting January 1, 2027, treatment services by qualified audiologists would also be covered. Audiologists could provide these services without a doctor referral or supervision. The bill also says these changes cannot be read to let Medicare pay more providers or services than were payable on December 31, 2026.

Audiologists allowed in community clinics

If enacted, qualified audiologists would be eligible providers at Rural Health Clinics and Federally Qualified Health Centers. This could make hearing and balance care easier to get in rural and underserved areas. The change would apply to services furnished on or after January 1, 2027.

20% coinsurance for audiology visits

If enacted, Medicare would pay 80% of the lower of the provider's charge or Medicare's fee schedule for audiology services. That means you would pay 20% coinsurance on the allowed amount for each audiology service unless other coverage pays it. This payment rule would apply to services furnished on or after January 1, 2027.

Sponsors & CoSponsors

Sponsor

Elizabeth Warren

MA • D

Cosponsors

  • Rand Paul

    KY • R

    Sponsored 6/9/2025

  • Chuck Grassley

    IA • R

    Sponsored 6/9/2025

  • Jeanne Shaheen

    NH • D

    Sponsored 6/9/2025

  • Peter Welch

    VT • D

    Sponsored 6/9/2025

  • Angus King

    ME • I

    Sponsored 6/9/2025

  • Amy Klobuchar

    MN • D

    Sponsored 6/9/2025

  • Cory Booker

    NJ • D

    Sponsored 6/9/2025

Roll Call Votes

No roll call votes available for this bill.

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