Reimbursement for Services Rendered by Audiology and OTO-Techs

The AAO-HNS supports the use of appropriately trained audiology and otolaryngology technicians in practice when clinically appropriate and accepted under state licensure laws for the state in which they are providing care. The Academy firmly believes that providers’ ability to bill appropriately is critical to ensuring patients’ access to these important services.

The Centers for Medicare & Medicaid Services (CMS) recognizes that certain audiologic diagnostic tests may be performed by a qualified technician when applicable state licensure and scope-of-practice laws permit. For example, CMS Local Coverage Determination (LCD) L35007 – Vestibular and Audiologic Function Studies states that “the technical components of certain audiological diagnostic tests, e.g., vestibular function tests that do not require the skills of an audiologist may be performed by a qualified technician or by an audiologist, physician, or nonphysician practitioner (NPP) acting within his/her scope of practice when the qualifications as outlined in the Training and Competency section of the policy are met.”[i] Physicians and practices should always adhere to guidance from their local Medicare Administrative Contractor regarding coverage, supervision, documentation, and billing requirements for technicians. To find your MAC’s website, click here.

Services furnished by a technician must be provided under the required level of physician supervision. The AAO-HNS supports compliance with current Medicare requirements for direct supervision of audiology services. According to CMS, because audiology services are diagnostic tests, when furnished in an office or hospital outpatient department, they must be furnished by or under the appropriate level of supervision of a physician. As of January 1, 2026, CMS allows supervising physicians and providers to provide supervision virtually via two way audio and video communication in addition to in-person, with a key element being their immediate availability if needed.

Table 1 below indicates which CPT codes have split components, where a technician could perform the technical component, but a physician or audiologist must perform the professional component. The medical record must contain the name and professional information of the technician who actually performed the service, and the service must be ordered by a qualified physician.

Table 1

[i]Centers for Medicare & Medicaid Services. Local Coverage Determination L35007: Vestibular and Audiologic Function Studies. https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?LCDId=35007

Published: August 11, 2026

Important Disclaimer Notice (Updated 7/31/14)

Position statements are approved by the American Academy of Otolaryngology–Head and Neck Surgery or Foundation (AAO-HNS/F) Boards of Directors and are typically generated from AAO-HNS/F committees. Once approved by the Academy or Foundation Board of Directors, they become official position statements and are added to the existing position statement library. In no sense do they represent a standard of care. The applicability of position statements, as guidance for a procedure, must be determined by the responsible physician in light of all the circumstances presented by the individual patient. Adherence to these clinical position statements will not ensure successful treatment in every situation. As with all AAO-HNS/F guidance, this position statement should not be deemed inclusive of all proper treatment decisions or methods of care, nor exclusive of other treatment decisions or methods of care reasonably directed to obtaining the same results. Position statements are not intended to and should not be treated as legal, medical, or business advice.