Audiology and Speech Center Fees

Fee Description	Amount
Evaluation of Speech/Voice Device (per hour)	$95.00
Modification of Speech/Voice Device (per hour)	$70.00
Assistive Technology for Literacy: Assessment	$130.00
Assistive Technology for Literacy: Intervention	$70.00
Speech-Language and/or Hearing Screening	$20.00
92506 Evaluation of Speech, Language, Voice, Communication, and/or Auditory Processing	$125.00
Office Consultation (per hour)	$80.00
92507 Treatment of Speech, Language, Voice, Communication, and/or Auditory Processing Disorder; Individual	$70.00
92508 Treatment of Speech, Language, Voice, Communication and/or Auditory Processing Disorder; Group 2, or more (per hour)	$35.00
92610 Evaluation of Oral and Pharyngeal Swallowing Function (per hour)	$200.00
92526 Treatment of Swallowing Dysfunction and/or Oral Function for Feeding (per hour)	$65.00
92601 Diagnostic Analysis of Cochlear Implant, Patient Younger Than 7 Years of Age; With Programming (per hour)	$70.00
92602 Diagnostic Analysis of Cochlear Implant, Patient Younger than 7 Years of Age; with Subsequent Programming (per hour)	$70.00
92603 Diagnostic Analysis of Cochlear Implant, Age 7 or Older; with Programming (per hour)	$70.00
92604 Diagnostic Analysis of Cochlear Implant, Age 7 or Older; with Subsequent Programming (per hour)	$70.00
96105 Assessment of Aphasia (Includes Assessment of Expressive and Receptive Speech and Language Function, Language Comprehension, Speech Productions Ability, Reading, Spelling, Writing, e.g. by Boston Diagnostic Aphasia Exam) with Interpretation and Report, per Hour	$75.00
96110 Developmental (Screening), with Interpretation and Report (Per Standardized Instrument Form)	$20.00
96111 Developmental Testing, (Includes Assessment of Motor, Language, Social, Adaptive, and/or Cognitive Functioning by Standardized Developmental Instruments) with Interpretation and Report	$125.00
96125 Standardized Cognitive Performance Testing (e.g. Ross Information Processing Assessment) per Hour of a Qualified Health Care Professional's Time, Both Face to Face Time Administering Tests to the Patient and Time Interpreting These Test Results and Preparing the Report *Must Be Billed with "GN" Modifier	$105.00
Modification of Speech/Voice Device (per hour)	$70.00
97532 Development of Cognitive Skills to Improve Attention, Memory, Problem Solving (Includes Compensatory Training), Direct (One-on-One) Patient Contact by the Provider, Each 15 Minutes	$15.00
92607 Evaluation for Prescription for Speech-Generating Augmentative and Alternative Communication Device, Face-to-Face with the Patient; First Hour	$175.00
92608 Evaluation for Prescription for Speech-Generating Augmentative and Alternative Communication Device, Face-to-Face with the Patient; Each Additional 30 Minutes	$75.00
92605 Evaluation for Prescription of Non-Speech Generating Augmentative and Alternative Communication Device, Face-to-Face with the Patient; First Hour	$125.00
92618 Evaluation for Prescription of Non-Speech Generating Augmentative and Alternative Communication Device, Face-to-Face with the Patient; Each Additional 30 Minutes	$80.00
92609 Therapeutic Service(s) for the Use of Speech-Generating Device, Including Programming and Modification	$70.00
92606 Therapeutic Service(s) for the Use of Non-Speech Generating Device, Including Programming and Modification	$70.00
Assistive Technology for Literacy: Assessment	$130.00
Assistive Technology for Literacy: Intervention	$70.00
92551 Screening Test, Pure Tone, Air Only	$20.00
92552 Pure Tone Audiometry (Threshold); Air Only	$20.00
92553 Pure Tone Audiometry Air & Bone	$35.00
92556 Speech Audiometry Threshold; with Speech Recognition	$35.00
92557 Comprehensive: Audiometry Threshold Evaluation and Speech and Speech Recognition (92553 and 92556 Combined)	$70.00
92558 Evoked Otoacoustic Emissions, Screening (Qualitative Measurement of Distortion Product or Transient Evoked Otoacoustic Emissions), Automated Analysis	$20.00
92626 Evaluation of Auditory Rehabilitation; First Hour	$125.00
92627 Evaluation of Auditory Rehabilitation Status; Each Additional 15 Minutes	$25.00
92630 Auditory Rehabilitation; Pre-Lingual Hearing Loss	$65.00
92633 Auditory Rehabilitation; Post-Lingual Hearing Loss	$70.00
92567 Typmanometry (Impedance Testing)	$20.00
92550 Tympanometry and Reflex Threshold Measurements	$30.00
92585 Auditory Evoked Potentials for Evoked Response Audiometry and/or Testing of the Central Nervous System; Comprehensive	$125.00
92586 Auditory Evoked Potentials for Evoked Response Audiometry and/or Testing of the Central Nervous System; Limited	$60.00
92587 (Distortion Product) Evoked Otoacoustic Emissions; Limited (Evaluation) (To Conform the Presence or Absence of Hearing Disorder, 3-6 Frequencies) (Or Transient Evoked Otoacoustic Emissions, with Interpretation and Report)	$40.00
92588 (Distortion Product) Evoked Otoacoustic Emissions; Comprehensive or Diagnostic Evaluation (Quantitative Analysis of Outer Hair Cell Function by Cochlear Mapping, Minimum of 12 Frequencies) (with Interpretation and Report)	$80.00
92563 Tone Decay Test	$20.00
92565 Stenger Test, Pure Tone	$20.00
92568 Acoustic Reflex Testing; Threshold	$20.00
92577 Stenger Test, Speech	$20.00
92570 Acoustic Immittance Testing Includes Tympanometry (Impedance Testing), Acoustic Reflex Threshold Testing, and Acoustic Reflex Decay Testing (Do Not Report 92570 in Conjunction with 92567, 92568)	$40.00
Off-Site Consultation (per hour)	$80.00
HEARING AID SERVICES
97755 ALD Exam & Selection	$70.00
92590 Hearing Aid Exam & Selection: Monaural	$65.00
92591 Hearing Aid Exam & Selection: Binaural	$65.00
92592 Hearing Aid Check: Monaural	$30.00
92593 Hearing Aid Check: Binaural	$30.00
V5014 Repair Aid - Hearing Aid Repair/Service: Out of Warranty	Cost x 1.5
V5014 Repair Aid - Hearing Aid Extended Warranty	Cost x 1.5
92594 Electroacoustic Analysis: Monaural
92595 Electroacoustic Analysis: Binaural
97703 Hearing Aid: Fit/Orientation/Check
V5010 Hearing Aid Assessment
V5020 Conformity Check/Real Ear Measurement
Hearing Aids (Conventional)	*Acquisition Cost x 2.8
Hearing Aid Monaural V5060 BTE/ V5050 ITE/ V52343 ITC/ V5242 CIC	*Acquisition Cost x 2.8
Hearing Aid Binaural V5140 BTE/ V5130 ITE/ V5249 ITC/ V5248 CIC	*Acquisition Cost x 2.8
HA CROS V5170 ITE/ V5180 BTE	*Acquisition Cost x 2.8
HA BICROS V5210 ITE/ V5220 BTE	*Acquisition Cost x 2.8
Hearing Aids (Programmable)	*Acquisition Cost x 2.0
HA Prog. Analog Monaural V5247 BTE/ V5246 ITE/ V5245 ITC/ V5244 CIC	*Acquisition Cost x 2.0
HA Prog. Analog Binaural V5253 BTE/ V5252 ITE/ V5251 ITC/ V5250 CIC	*Acquisition Cost x 2.0
Hearing Aids (Digital Signal Processing)	*Acquisition Cost x 1.7
HA Digital Monaural V5257 BTE/ V5256 ITE/ V5255 ITC/ V5254 CIC	*Acquisition Cost x 1.7
HA Digital Binaural V5261 BTE/ V5260 ITE/ V5259 ITC/ V5258 CIC	*Acquisition Cost x 1.7
Assistive Listening Devices (ALDs)	Mfr. Sug. Retail Price
V5268 ALD Telephone Amplifier	Mfr. Sug. Retail Price
V5269 ALD Alerting	Mfr. Sug. Retail Price
V5270 ALD TV Amplifier	Mfr. Sug. Retail Price
V5272 ALD TDD	Mfr. Sug. Retail Price
V5273 ALD for US with CI	Mfr. Sug. Retail Price
V5275 Ear Impression	Mfr. Sug. Retail Price
V5299 Miscellaneous Service	Mfr. Sug. Retail Price
Miscellaneous	*Acquisition Cost x 2.0
V5090 Dispensing Fee Unspecified	$200.00
V5160 Dispensing Fee HA Binaural	$300.00
V5262 Disposable Hearing Aid	*Acquisition Cost x 2.0
V5264 Earmold Services (Swim Plugs or Earmolds)	*Acquisition Cost x 2.0
V5264 Earmold Services (Musician)	*Acquisition Cost x 1.5
V5265 Earmold Disposable Hearing Aid	*Acquisition Cost x 2.0
V5266 Batteries	* Acquisition Cost x 2.0
V5267 Hearing Aid Accessory	*Acquisition Cost x 2.0
Tinnitus Maskers	*Acquisition Cost x 2.0
Central Auditory Procesing Educational Report	$60.00
92620 Evaluation of Central Auditory Function, with Report; Initial 60 minutes	$100.00
92621 - Each Additional 15 Minutes	$20.00
92625 Assessment of Tinnitus (Including pitch, Loudness Matching and Masking) - (Do not report 92625 in Conjunction with 92562) (For Unilateral Assessment, Use Modifier 52)	$65.00
Hyperacusis Evaluation	$65.00
97112 Therapeutic Procedure, One or More Areas, Each 15 Minutes; Neuromuscular Reeducation of Movement, Balance, Coordination, Kinesthetic sense, Posture, and/or Proprioception for Sitting and/or Standing Activities - Vestibular Rehabilitation (per hour)	$15.00
92540 Basic Vestibular Evaluation, Includes Spontaneous Nystagmus Test with Eccentric Gaze Fixation Nystagmus with Recording, Positional Nystagmus Test, Minimum of 4 Positions, with Recording, Optokinetic Nystagmus Test, Bidirectional Foveal and Peripheral Stimulation, with Recording, and Oscillating Tracking Test, with Recording. (Do Not Report 92540 in Conjunction with 92541, 92542, 92544 and 92545)	$180.00
92541 Spontaneous Nystagmus Test, Including Gaze and Fixation Nystagmus, with Recordings - Spontaneous Nystagmous Test	$45.00
92542 Positional Nystagmus Test, Minimum of 4 Positions, with Recording	$65.00
Evaluation of Speech/Voice Device (per hour)	$95.00
92543 Caloric Vestibular Test, Each Irrigation (Binaural, Bithermal Stimulation Constitutes four Tests), with Recording	$12.00
92532 Positional Nystagmous Test	$45.00
92543 Caloric Vestibular Test, Each Irrigation (Binaural, Bithermal Stimulation Constitutes four Tests), with Recording	$12.00
92534 Optokinetic Nystagmous Test	$45.00
92545 Oscillating Tracking Test, with Recording	$45.00
92547 Use of Verical Electrodes (Used in Conjunction with 92541-92546) (For Unlisted Vestibular Tests, Use 92700)Use of Electrodes	$45.00
*Acquisition Cost refers to single-unit cost.
A sliding scale, or the Health & Human Services guidelines on poverty, will be used if the client has no insurance and if the family income and the number of dependents indicates there is a need. The sliding scale is detailed in Appendix A.

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