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Audiology health service, consisting of brain stem evoked response audiometry, performed on a patient by an eligible audiologist if:

(a) the service is not for the purposes of programming either an auditory implant or the sound processors of an auditory implant; and

(b) the service is performed pursuant to a written request made by a medical practitioner to assist in the diagnosis, treatment or management of ear disease or a related disorder in the patient; and

(c) the service is not performed for the purpose of a hearing screening; and

(d) the service is performed on the patient individually and in person; and

(e) after the service, the eligible audiologist provides a copy of the results of the service performed, together with relevant comments in writing that the eligible audiologist has on those results, to the medical practitioner who requested the service; and

(f) a service to which item 11300 applies has not been performed on the patient on the same day

Fee: $175.40 Benefit: 85% = $149.10

(See para MN.15.5 of explanatory notes to this Category)

Extended Medicare Safety Net Cap: $500.00

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