Medicare Bill Grants Seniors Direct Access to Audiologists for Treatment Starting 2027

The Medicare Audiology Access Improvement Act of 2025 is setting up a major shift in how Medicare beneficiaries get hearing and balance care. Starting January 1, 2027, this bill expands Medicare coverage to include treatment services provided by qualified audiologists, moving beyond the assessment-only services currently covered (SEC. 2).

Cutting the Middleman: Direct Access to Care

The most significant change here is that patients will no longer need a physician’s referral or supervision to see an audiologist for covered treatment services. Historically, Medicare has limited audiologists to diagnostic tests unless the services were incident to a physician’s care. This bill changes that by explicitly stating that a qualified audiologist can furnish these services independently, without the patient needing to be under the care of or supervised by another practitioner (SEC. 2).

Think of it this way: If you’re a retired construction worker who needs follow-up treatment for hearing loss or balance issues, you won't have to schedule two appointments—one with your primary care doctor just to get a referral, and then one with the specialist. You can go straight to the audiologist for the covered treatment, saving time, co-pays, and hassle. This is a huge win for convenience and timely care, especially for people with chronic conditions.

Expanding the Map: Care in Rural Areas

This legislation also addresses a major access problem by explicitly including qualified audiologists as practitioners in Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) (SEC. 2). For people living in rural areas where specialist access is already tough, this means that the local clinic might soon be able to offer necessary hearing and balance treatments directly. This integration helps close the gap in specialty care that often exists outside of major metropolitan areas.

The Fine Print: What’s Covered and How They Pay

While this bill expands access, it’s important to note the scope. The new coverage is for audiology treatment services that would normally be covered if a physician provided them (SEC. 2). This means the services added are specific treatments, not necessarily things like routine hearing aids, which are generally not covered by Medicare. The bill essentially allows audiologists to bill for services previously limited to physicians.

Regarding payment, Medicare will cover 80% of the lesser amount between what the audiologist charges and the established fee schedule amount, which is the standard payment mechanism for many specialist services (SEC. 2). While this expansion is great for access, it will inevitably increase the total amount Medicare spends on these services, although the bill text doesn't quantify that cost. It’s a trade-off: better access for beneficiaries means higher program expenditures.