Fair Square Medicare Wordmark

Does Medicare Require a Referral for Audiology Exams?

Senior woman receiving an ear exam stock photo
By Daniel Petkevich
Nov 22, 2022

Guidance has been updated recently

As you may know already, Medicare does not cover hearing aids. But you can still get Medicare coverage for tests for hearing and balance. In most cases, you will need a referral from a physician to get this covered by Medicare. The CMS (Center for Medicare & Medicaid Services) just released updated guidance for the exception for when you don't need a referral. Let's dig into it.

Stay Up to Date on Medicare!

Join the Fair Square Medicare Newsletter to stay informed on cost savings, changes to Medicare, and other valuable healthcare information.

When do you need an audiology exam?

You will need an audiology exam if you want to find out how well your ears are working and to determine the best treatment for any hearing issues. This may include having balance tests and learning more about assistive devices such as hearing aids, implants, or other treatments.

Audiology Exams and Medicare Coverage

Luckily, if you need an audiology exam, Medicare has you covered. This exam does require pre-authorization though. The exam must be performed by an audiologist who is an enrolled Medicare provider. If you do not have a referral from your physician, you may be able to use the Exception Request, which has recently been filed with the CMS.

What are the conditions that must be met for the exception to apply?

According to the CMS, "(t)he finalized policy will allow beneficiaries direct access (without an order from a physician or NPP) to an audiologist, but only for non-acute hearing conditions." So , if your hearing condition is not acute or emergent, and you are being seen for non-acute issues, then Medicare will need authorize the audiology exam to be eligible for coverage.

What to do if you don't have a referral?

If you don't have a referral from your physician for an audiology exam and meet the criteria for the exception, you may submit an Exception Request to Medicare. This must be done before the exam is performed, and you will need to provide all supporting documentation such as physician notes and lab results with your request. Once approved, Medicare will pay for the exam and any related services.
And as with hearing aids, Medicare might not have the same coverage as Medicare Advantage plans. You might want to check with your plan provider directly for specific coverage details.
We hope this guide helps you understand what Medicare covers regarding audiology exams. If you have any questions, please don't hesitate to reach out to us for more information. We're here to help!

Stay Up to Date on Medicare!

Join the Fair Square Medicare Newsletter to stay informed on cost savings, changes to Medicare, and other valuable healthcare information.

Recommended Articles

Visiting a hospital front desk illustrated stock image
Do All Hospitals Accept Medicare Advantage Plans?
Apr 11, 2023
Cover image
How Are Medicare Star Ratings Determined?
Sep 6, 2023
older man suffering from stomach pain due to IBS stock photo
Does Medicare Cover Xiafaxan?
Jan 19, 2023
Leg bones and knees, 3d rendering. stock photo
Does Medicare Cover Fosamax?
Nov 30, 2022
Nasal spray stock image
Can Medicare Help with the Cost of Tyrvaya?
Jan 12, 2023
woman sitting up in bed experiencing back pain stock photo
Does Medicare Cover a Spinal Cord Stimulator?
Nov 19, 2022
Older woman during an eye exam
Does Medicare Cover Diabetic Eye Exams?
Jan 11, 2023
pros and cons stock image
Are Medicare Advantage Plans Bad?
May 5, 2022
Medicare Part A & Part B stock photo
How Much Does Medicare Part A Cost in 2025?
Nov 18, 2022
Hepatitis C stock photo
Does Medicare Cover Hepatitis C Treatment?
Nov 22, 2022
A doctor with a clipboard consults a female patient with cancer
Does Medicare Cover Inqovi?
Jan 11, 2023
Senior woman checking blood pressure/heart rate at home stock photo
Does Medicare Cover Home Heart Monitors?
Dec 1, 2022
Cover image
What Is a Medicare Advantage POS Plan?
May 10, 2023
doctor consulting their patient stock image
Does Medicare Cover the Urolift Procedure?
Dec 6, 2022
Arizona desert stock photo
13 Best Ways for Seniors to Stay Active in Phoenix
Mar 6, 2023
Hands of doctor or nurse in medical gloves injecting a shot to a man patient stock photo
Does Medicare Pay for Allergy Shots?
Nov 29, 2022
Senior man receiving care from an optometrist stock photo
Does Medicare Cover Cataract Surgery?
Dec 22, 2022
senior couple working in a greenhouse stock image
Medicare Supplement Plans for Low-Income Seniors
Mar 23, 2023

More of our articles

13 Best Ways for Seniors to Stay Active in Philadelphia

14 Best Ways for Seniors to Stay Active in Nashville

Building the Future of Senior Healthcare

Can Doctors Choose Not to Accept Medicare?

Can I Change Medicare Advantage Plans Any Time? | Medicare Plans

Costco Pharmacy Partners with Fair Square

Do I Need to Renew My Medicare?

Do You Need Books on Medicare?

Do You Need Medigap if You're Eligible for Both Medicare and Medicaid?

Does Medicare Cover an FMT?

Does Medicare Cover Bariatric Surgery?

Does Medicare Cover Boniva?

Does Medicare Cover Cardiac Ablation?

Does Medicare Cover Cervical Disc Replacement?

Does Medicare Cover Cold Laser Therapy (CLT)?

Does Medicare Cover Compounded Medications?

Does Medicare Cover Cosmetic Surgery?

Does Medicare Cover COVID Tests?

Does Medicare Cover Disposable Underwear?

Does Medicare Cover Driving Evaluations?

Does Medicare Cover Geri Chairs?

Does Medicare Cover Hearing Aids?

Does Medicare Cover Ketamine Infusion for Depression?

Does Medicare Cover Kidney Stone Removal?

Does Medicare Cover Linx Surgery?

Does Medicare Cover Medical Marijuana?

Does Medicare Cover Mental Health?

Does Medicare Cover Nexavar?

Does Medicare Cover Penile Implant Surgery?

Does Medicare Cover Robotic Surgery?

Does Medicare Cover RSV Vaccines?

Does Medicare Cover Service Animals?

Does Medicare Cover SI Joint Fusion?

Does Medicare Cover SIBO Testing?

Does Medicare Cover Stair Lifts?

Does Medicare Cover TENS Units?

Does Medicare Cover the WATCHMAN Procedure?

Does Medicare Cover Wart Removal?

Does Medicare Pay for Antivenom?

Does Medicare Require a Referral for Audiology Exams?

Explaining the Different Enrollment Periods for Medicare

Fair Square Client Newsletter: AEP Edition

How Can I Get a Replacement Medicare Card?

How Do I Sign up for Medicare? A Simple How-To Guide For You

How Do Medicare Agents Get Paid?

How Does Medicare Pay for Emergency Room Visits?

How Does the End of the COVID-19 Public Health Emergency Affect Your Medicare?

How Medicare Costs Can Pile Up

How Much Does a Pacemaker Cost with Medicare?

How Much Does Medicare Part B Cost in 2025?

How to Become a Medicare Agent

How to Choose a Medigap Plan

How Your Employer Insurance and Medicare Work Together

Is Botox Covered by Medicare?

Is Displacement Affecting Your Medicare Coverage?

Is Gainswave Covered by Medicare?

Medicare Guaranteed Issue Rights by State

Medicare Savings Programs in Kansas

Medigap vs. Medicare Advantage

Plan G vs. Plan N

Saving Money with Alternative Pharmacies & Discount Programs

Should You Work With A Remote Medicare Agent?

The Easiest Call You'll Ever Make

Welcome to Fair Square's First Newsletter

What Does Medicare Cover for Stroke Patients?

What Happens to Unused Medicare Set-Aside Funds?

What If I Don't Like My Plan?

What Is a Medicare Supplement SELECT Plan?

What Is the Medicare Birthday Rule in Nevada?

When to Choose Medicare Advantage over Medicare Supplement

Which Medigap Policies Provide Coverage for Long-Term Care?

Will Medicare Cover it?

Your Medicare One-Stop-Shop

Your guide to Medicare Parts A & B, Medicare Advantage, and Medigap. 100% free.
Get the Fair Square Bulletin

Medicare savings tips, helpful guides, and more.

About

Medicare 101

Current Clients

Medicare Supplement Plans

Medicare Advantage Plans

Fair Square 2025

Terms of Use
Notice of Privacy Practices

Virgil Insurance Agency, LLC (DBA Fair Square Medicare) and www.fairsquaremedicare.com are privately owned and operated by Help Button Inc. Medicare supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. This is a solicitation of insurance. A licensed agent/producer may contact you. Medicare Supplement insurance is available to those age 65 and older enrolled in Medicare Parts A and B and, in some states, to those under age 65 eligible for Medicare due to disability or End-Stage Renal disease. Virgil Insurance Agency is a licensed and certified representative of Medicare Advantage HMO, HMO SNP, PPO, PPO SNP and PFFS organizations and stand-alone PDP prescription drug plans. Each of the organizations we represent has a Medicare contract. Enrollment in any plan depends on contract renewal. The plans we represent do not discriminate on the basis of race, color, national origin, age, disability, or sex. Plan availability varies by region and state. For a complete list of available plans please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov. © 2025 Help Button Inc

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.

MULTIPLAN_FairSquareMedicare_01062022_M