Cal. Code Regs. tit. 22, § 51507.2
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
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.
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).