§ 51507.2. Speech Therapy and Audiology.

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		Maximum
Code		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)

Procedure		Maximum
Code		Allowance
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

HISTORY

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

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.