California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 3 - Health Care Services › Article 7 - Payment for Services and Supplies › Section 51507.2 - Speech Therapy and Audiology

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Reimbursement for speech therapy and audiology services
						shall be the usual charges made to the general public not to exceed the
						following maximum reimbursement rates.
AUDIOLOGY
Basic Procedures
Procedure
								Code
Maximum
								Allowance
X4500
Diagnostic audiological evaluation,
								including pure tone audiometry, speech reception threshold and
								discrimination
$66.05
X4501
Pure tone audiometry (with complete
								audiogram)
35.79
X4502
Audiological preliminary evaluation
								in a rehabilitation center, SNF, ICF, or subacute care
								facility
33.03
V5008
Hearing screening
18.07
X4504
Audiometry during surgery
By
								Report
Pediatric Evaluation (0-7 Years)
X4506
First Visit
77.05
X4508
First diagnostic
								follow-up
42.15
X4510
Second diagnostic
								follow-up
42.15
Evaluation for Site of Lesion (Following Procedure
								X4500)
X4512
Bekesy audiometry
37.64
X4514
Short Increment Sensitivity Index
								(S.I.S.I.)
15.05
X4516
Loudness balance
								test
15.05
X4518
Tone decay test
15.05
Other Audiological Services
(Following Audiological Evaluation
								Procedures)
X4520
Visual evoked potential response
								test, medical diagnosis
$160.10
X4522
Evoked response audiometry test,
								physician evaluation
160.10
X4524
Somatosensory evoked response test
								1/more nerves, physician evaluation
160.10
X4526
Hearing therapy (individual) per
								hour
45.40
X4528
Hearing therapy (group), each
								patient
26.57
X4530
Impedance audiometry
								(bilateral)
33.14
V5010
Assessment for hearing aid (following
								procedures X4500, X4506, X4508, or X4510)
52.70
X4532
Electroacoustic analysis of hearing
								aid as a monaural procedure
23.32
V5264
Ear mold/insert, not disposable, any
								type
27.52
V5265
Ear mold/insert, disposable, any
								type
By Report
X4534
Out-of-office call (Payable only for
								visits to the first patient receiving services at any given location on the
								same day)
8.27
X4536
Weber test
7.53
X4538
Impedance audiometry
								(unilateral)
15.21
X4540
Tympanometry
22.94
X4542
Electroacoustic analysis of hearing
								aid as a binaural procedure
42.81
X4544
Diagnostic evaluation for severely
								physically/mentally handicapped person over seven years of
								age
84.75
X4546
Electronystagmography
89.83
X4535
Unlisted audiological
								services
By Report
SPEECH--LANGUAGE SERVICES
X4300
Language
								evaluation
$66.05
X4301
Speech evaluation
66.05
X4302
Speech--Language therapy (group) each
								patient
26.57
X4303
Speech--Language therapy (individual)
								per one hour (following procedures X4300 or X4301)
45.24
X4304
Speech--language therapy, individual,
								per half hour
22.63
X4306
Out-of-office call (Payable only for
								visits to the first patient receiving services at any given location on the
								same day)
8.27
X4308
Speech therapy preliminary evaluation
								in a rehabilitation center, SNF, ICF, or subacute care
								facility
33.03
X4310
Augmentative and Alternative
								Communication (AAC) related bundled speech therapy services, per
								visit
45.24
X4312
AAC recipient assessment
By
								Report
X4320
Unlisted speech therapy
								services
By Report
1.
						Amendment filed 8-1-84 as an emergency; effective upon filing (Register 84, No.
						31). A Certificate of Compliance must be transmitted to OAL within 120 days or
						emergency language will be repealed on 11-29-84. For prior history, see
						Register 81, No. 52.
2. Certificate of Compliance transmitted to OAL
						11-27-84 and filed 12-27-84 (Register 84, No. 52).
3. Amendment
						filed 8-1-85 as an emergency; effective upon filing (Register 85, No. 32). A
						Certificate of Compliance must be transmitted to OAL within 120 days or
						emergency language will be repealed on 11-29-85.
4. Certificate of
						Compliance transmitted to OAL 11-20-85 and filed 12-27-85 (Register 85, No.
						52).
5. Editorial correction replacing text dropped in 4-1-90
						printing (Register 91, No. 14).
6. Repealer and new section filed
						9-25-92 as an emergency; operative 10-1-92 (Register 92, No. 40). A Certificate
						of Compliance must be transmitted to OAL 1-25-93 or emergency language will be
						repealed by operation of law on the following day.
7. Certificate of
						Compliance as to 9-25-92 order transmitted to OAL 1-22-93 and filed 3-9-93
						(Register 93, No. 11).
8. Amendment of procedure codes X4506 and
						V5010, and new procedure codes X4310 and X4312 filed 7-28-97 as an emergency;
						operative 7-28-97 (Register 97, No. 31). A Certificate of Compliance must be
						transmitted to OAL by 11-25-97 or emergency language will be repealed by
						operation of law on the following day.
9. Certificate of Compliance
						as to 7-28-97 order transmitted to OAL 11-19-97 and filed 1-6-98 (Register 98,
						No. 2).
10. Redesignation and amendment of section as subsection
						(a), new subsection (b) and amendment of NOTE filed 7-16-2002; operative rates
						for services provided on or after 8-1-2000 pursuant to Stats. 2000, c. 52,
						Items 4260-101-0001 and 0890 (Register 2002, No. 29).
11.
						Certificate of Compliance as to 7-16-2002 order, including repealer of
						subsection (a) designator and subsection (b), transmitted to OAL 11-12-2002 and
						filed 12-24-2002 (Register 2002, No. 52).
12. Amendment filed
						4-4-2003 as an emergency; operative 4-4-2003 (Register 2003, No. 14). A
						Certificate of Compliance must be transmitted to OAL by 8-4-2003 or emergency
						language will be repealed by operation of law on the following
						day.
13. Certificate of Compliance as to 4-4-2003 order transmitted
						to OAL 7-28-2003 and filed 9-4-2003 (Register 2003, No.
						36).
Note: Authority cited: Sections
						  10725,
						  14105
						  and
						  14124.5,
						  Welfare and Institutions Code. Reference: Section
						  14105,
						  Welfare and Institutions Code; Statutes of 1984, Chapter 258, Items
						  4260-106-001 and 890; Statutes of 1985, Chapter 111, Items 4260-106-001 and
						  890; and Statutes of 2000, Chapter 52, Items 4260-101-0001 and
						  0890.