Part B covers ancillary services after the first 100 days of Part A services have been exhausted. Outpatient services except home health and hospice care are also covered. This is a Medicare per hour payment limit that applies to contracted practitioners only. It is expected to be implemented for speech-language pathology and occupational therapy services in mid to late 1997. The Medicare payment is intended to be roughly equivalent to what a facility would pay a salaried practitioner, including fringe benefits, taxes, and administrative expenses.
Payment is made for the practitioner's total time in the facility.
Audiologists may receive Medicare payments directly as independent practitioners. Practitioners billing through physicians' offices or medical clinics must be employees , not contractors. A physician referral must be noted in the clinical record. Verbal orders must be documented in the record by a nurse or speech-language pathologist followed soon thereafter with written confirmation by the physician. For independently practicing audiologists, each carrier may dictate whether the physician's written referral is required.