Orders and the AB modifier
Medicare generally requires a physician order for audiology tests. Since 2023, patients can see an audiologist without one once every 12 months for certain non-acute hearing tests, billed with the AB modifier.
Diagnostic tests bill one way, hearing aids another
Medicare pays audiologists for diagnostic hearing and balance tests, but not for hearing aids or the exams to fit them. Taiga drafts codes from your notes for audiologist approval and works every denial. Audiology is not on its published specialty list, so start with a fit check.
Book a demoThe audiology billing split
Audiologists have their own Medicare benefit, with sharper edges than many practices expect.
Balance testing still needs an order
Direct access does not cover tests for disequilibrium or imbalance. Vestibular work needs an order on file before the claim goes out.
Hearing aids sit outside Medicare
Original Medicare does not cover hearing aids or fitting exams, and audiologists cannot bill incident to a physician. Cochlear and other implanted hearing devices fall under a separate prosthetic device benefit.
Drawing the line
Diagnostic claims and device sales rarely share one workflow.
The practice keeps
Test results, interpretations, orders, and the hearing aid sales process. The audiologist approves each code.
Taiga takes on
Diagnostic claims: eligibility checks, scrubbing, submission, patient statements, and every denial and appeal.
Needs a decision
Decide how hearing aid benefits from commercial and Medicare Advantage plans, and patient-pay device balances, are handled before any handoff.
Before an audiology fit call
Bring a de-identified test report, an order, and a recent denial. Keep patient details out of the booking form.
How much is diagnostic work?
Estimate the share of revenue from covered testing versus hearing aid and accessory sales.
How do patients reach you?
Note how often patients arrive with an order, through direct access, or by referral from an ENT practice.
Do you work with implants?
List cochlear implant candidacy and programming work and how it is billed today.
A likely fit
Independent audiology practices with meaningful diagnostic volume that want an experienced team on claims and denials. Taiga works with your current EHR, with about two weeks from onboarding to first claim.
Not covered here
This page does not cover hearing aid retail pricing, device financing, or hospital outpatient audiology. It does not confirm Taiga support for audiology.
Questions about audiology billing
When do I use the AB modifier?
On certain diagnostic tests an audiologist personally furnishes without a physician order, once every 12 months per patient. CMS publishes the list of codes that may carry it.
Can balance testing use direct access?
No. Tests for disequilibrium or imbalance are excluded from direct access and still need an order.
Can audiology services be billed incident to a physician?
Not under Medicare. An audiologist bills covered diagnostic tests under their own NPI, for the work they perform themselves.
Does Taiga bill for audiology practices?
Audiology is not on Taiga's published specialty list. Bring your service mix and payers, and Taiga will tell you straight whether it fits.
Bring your audiology mix
Share your payers and how diagnostics and devices split. Taiga will tell you straight whether it fits.
System guides show possible billing handoffs, not proven specialty compatibility.