I 

117TH CONGRESS 

1ST SESSION H. R. 1587 

To provide certain coverage of audiologist services under the Medicare 

program, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

MARCH 3, 2021 

Mr. RICE of South Carolina (for himself, Mr. CARTWRIGHT, Mr. KELLY of 

Pennsylvania, Mr. YOUNG, Mr. COLE, Mr. BILIRAKIS, Mr. RODNEY

DAVIS of Illinois, Ms. UNDERWOOD, Mr. NORMAN, Mr. COHEN, Mr. 

MCKINLEY, Mr. FITZPATRICK, Ms. WILD, Ms. MCCOLLUM, Mr. 

BUTTERFIELD, Mr. RESCHENTHALER, Mr. WELCH, Mr. RUTHERFORD, 

Mr. MASSIE, Mr. YARMUTH, Ms. BLUNT ROCHESTER, Mr. O’HALLERAN, 

Mrs. MCBATH, Mr. NEGUSE, Ms. SCHAKOWSKY, and Mr. FOSTER) introduced the following bill; which was referred to the Committee on Energy 

and Commerce, and in addition to the Committee on Ways and Means, 

for a period to be subsequently determined by the Speaker, in each case 

for consideration of such provisions as fall within the jurisdiction of the 

committee concerned 

A BILL 

To provide certain coverage of audiologist services under 

the Medicare program, and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Medicare Audiologist 

5 Access and Services Act of 2021’’. 


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1 SEC. 2. FINDINGS. 

2 Congress finds the following: 

3 (1) Individuals with mild hearing loss are 3 

4 times more likely to experience a fall, and falls are 

5 the leading cause of fatal injury for Americans over 

6 65. 

7 (2) Seniors with hearing loss are more likely to 

8 develop cognitive problems and experience cognitive 

9 decline up to 40 percent faster than those without 

10 hearing loss. 

11 (3) Untreated hearing loss can lead to depres12 sion, anxiety, and social isolation. 

13 (4) Timely access to diagnosis and treatment 

14 for hearing and vestibular conditions can improve 

15 outcomes for beneficiaries and reduce overall cost of 

16 care. 

17 (5) Licensed audiologists in all 50 States and 

18 the District of Columbia are health care profes19 sionals that are trained in the diagnosis, treatment 

20 and rehabilitation of individuals with hearing, bal21 ance, and related disorders. 

22 (6) The Medicare program covers a range of 

23 hearing health services, including diagnostic and 

24 therapeutic services. However, Medicare will only re25 imburse audiologists for a narrow set of diagnostic 

26 services—even when Medicare-covered treatment 


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1 services are in the scope of practice of audiologists. 

2 Medicare also requires patients to receive a physi3 cian order before even receiving diagnostic services 

4 from audiologists in order for those services to be 

5 covered by the Medicare program. 

6 (7) The Department of Defense Medical Health 

7 System, the Veterans Health Administration, the Of8 fice of Personnel Management (through many of its 

9 Federal Employees Benefit plans), and many Med10 icaid and private health plans provide patients ‘‘di11 rect access’’ to audiologists and do not condition re12 imbursement on referral by a physician. 

13 (8) The National Academy of Sciences, Engi14 neering, and Medicine issued a report, entitled 

15 ‘‘Hearing Health Care for Adults: Priorities for Im16 proving Access and Affordability,’’ which rec17 ommended that the Centers for Medicare and Med18 icaid Services ‘‘examine pathways for enhancing ac19 cess to assessment for and delivery of auditory reha20 bilitation services’’ through Medicare, ‘‘including re21 imbursement to audiologists for these services’’. 

22 (9) Administrative requirements for referral, 

23 plan of care, consultation with the attending physi24 cian or other health care practitioner, and oversight 

25 unnecessarily delay care and may increase costs. 


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1 (10) Medicare beneficiaries should have access 

2 to the same level of audiologic care as is available 

3 in the Veterans Administration, under the Federal 

4 Employees Health Benefits Program, and under pri5 vate insurance. 

6 SEC. 3. MEDICARE COVERAGE OF AUDIOLOGIST SERVICES. 

7 (a) IN GENERAL.—Section 1861(s) of the Social Se8 curity Act (42 U.S.C. 1395x(s)) is amended— 

9 (1) in paragraph (2)— 

10 (A) in subparagraph (A), by inserting ‘‘but 

11 excluding services furnished by a qualified audi12 ologist’’ before the semicolon; 

13 (B) in subparagraph (GG), by striking 

14 ‘‘and’’ at the end; 

15 (C) in subparagraph (HH), by striking the 

16 period at the end and inserting ‘‘; and’’; and 

17 (D) by adding at the end the following new 

18 subparagraph: 

19 ‘‘(II) audiologist services (as defined in 

20 subsection (ll)(3)).’’; and 

21 (2) in paragraph (3), by inserting ‘‘(including 

22 services supervised by a qualified audiologist but ex23 cluding services supervised by a qualified audiologist 

24 under the supervision of a physician or other health 

25 care practitioner)’’ before the semicolon. 


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1 (b) IMPROVED ACCESS TO AUDIOLOGIST SERV2 ICES.—Paragraph (3) of section 1861(ll) of the Social Se3 curity Act (42 U.S.C. 1395x(ll)) is amended to read as 

4 follows: 

5 ‘‘(3) The term ‘audiologist services’ means such diag6 nostic or treatment services furnished by a qualified audi7 ologist which the qualified audiologist is legally authorized 

8 to perform under State law (or the regulatory mechanism 

9 provided by State law), as would otherwise be covered if 

10 furnished by a physician or as an incident to a physician’s 

11 service, without regard to any requirement that the indi12 vidual receiving such audiologist services is under the care 

13 of (or referred by) a physician or other health care practi14 tioner or that such services are furnished under the super15 vision of a physician or other health care practitioner.’’. 

16 (c) PAYMENT UNDER THE PHYSICIAN FEE SCHED17 ULE.— 

18 (1) PROVISION FOR PAYMENT UNDER PART

19 B.—Section 1832(a)(2)(B)(iii) of the Social Security 

20 Act (42 U.S.C. 1395k(a)(2)(B)(iii)) is amended by 

21 inserting ‘‘audiologist services,’’ after ‘‘qualified psy22 chologist services,’’. 

23 (2) PAYMENT AMOUNT AND COINSURANCE.— 

24 Section 1833(a)(1) of such Act (42 U.S.C. 

25 1395l(a)(1)) is amended— 


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1 (A) by striking ‘‘and’’ before (DD); and 

2 (B) by inserting before the semicolon at 

3 the end the following: ‘‘, and (EE) with respect 

4 to audiologist services furnished under section 

5 1861(s)(2)(II), the amounts paid shall be 80 

6 percent of the lesser of the actual charge for 

7 the services or the fee schedule amount pro8 vided under section 1848’’. 

9 (3) PAYMENT ON ASSIGNMENT-RELATED

10 BASIS.—Section 1842(b)(18)(C) of such Act (42 

11 U.S.C. 1395u(b)(18)(C)) is amended by adding at 

12 the end the following new clause: 

13 ‘‘(vii) An audiologist.’’. 

14 (4) PAYMENT UNDER PHYSICIAN FEE SCHED15 ULE.—Section 1848(j)(3) of such Act (42 U.S.C. 

16 1395w–4(j)(3)) is amended by inserting ‘‘(2)(II),’’ 

17 before ‘‘(3),’’. 

18 SEC. 4. RULE OF CONSTRUCTION. 

19 Nothing in the amendments made by this Act shall 

20 be construed to expand the scope of audiologist services 

21 or the services for which payment may be made to other 

22 providers who may receive payment under title XVIII of 

23 the Social Security Act (42 U.S.C. 1395 et seq.) beyond 

24 those services for which such payment may be made as 

25 of December 31, 2021. 


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1 SEC. 5. EFFECTIVE DATE. 

2 The amendments made by this Act shall apply to 

3 items and services furnished on or after January 1, 2022. 

Æ 


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