Cal. Code Regs. tit. 22 § 51507.2
Current through Register 2024 Notice Reg. No. 50, December 13, 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 |
Cal. Code Regs. Tit. 22, § 51507.2
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.
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).