By David W. Holmes, PhD
MelMedtronics will release its new Tinnitus Evaluation Program (TEP) software in October. This product is Medicare-compliant and reimbursable, creating opportunity for an untapped revenue stream in audiology and otolaryngology practices. Medicare approved a new CPT code for tinnitus evaluation (CPT-92625) seven years ago, and four evaluation requirements comply with the procedure. Frequency match, intensity match, minimum masking level, and presence of residual inhibition must be documented for patients’ tinnitus measurements.
Medicare currently reimburses an average of $67.44 (depending on geographical area) for CPT-92625, with a diagnosis of subjective tinnitus (ICD-9, 388.31). No modifier is required. Fifty percent of patients in a typical audiology practice present with tinnitus, and the incidence is approximately 70 percent in an otolaryngology practice. Patients have long complained about providers telling them they would have to learn to live with their tinnitus, but this should no longer apply. MelMedtronics’ TEP provides an efficient method of evaluating tinnitus with a variety of treatments available.
Providers who register at www.melmedtronics.com can download the TEP software. The program generates revenue, is Medicare compliant, takes seven to 10 minutes to complete, and requires no capital outlay, monthly fee, or special equipment. It is also easy to administer, and is compatible with all platforms. TEP generates a clinical report that can be saved or printed, and the report can be downloaded to Windows, iOS, and tablets and integrated into emergency medical record software. A small fee-per-use applies to download the TEP system.
Potential Revenue Generated
An estimated 50 million individuals in the United States have tinnitus, and 50 to 70 percent who see an audiologist or otolaryngologist have tinnitus. Audiologists see 10 to 20 patients per day, and five to 10 have tinnitus; otolaryngologists see 30 to 50 patients per day, and 20 to 35 have tinnitus.
Audiologists evaluate 50 percent of their tinnitus patients (2.5-5 patients/day x $67.44 [Medicare’s average]), which equals $168.60 to $337.20 per day, or $40,464 to $80,928 per year. Otolaryngologists evaluate 50 percent of their tinnitus patients (10-17 patients/day x $67.44), which equals $674.40 to $1,146.48 per day, or $161,856 to $275,155.20 per year. Revenue generated per hour, based on a seven- to 10-minute procedure, is approximately $404.64 to $539.52.
How to Use the Software
Log in to your account after you have registered at www.melmedtronics.com, then download the software by clicking the icon on the desktop each time you evaluate a patient. The TEP will allow you to gather patient demographics, a brief history, match tinnitus frequency, match intensity level, determine masking level, and measure residual inhibition. The TEP will also generate a clinical report that can be saved to a file, integrated into your EMR, and printed. The entire evaluation can be completed in seven to 10 minutes.
Tinnitus Patients Have Been Ignored
Patients with tinnitus have historically been ignored for several reasons. Most forms of tinnitus are benign, and those that are not can be ruled out by history and additional tests. Tinnitus patients have not been an interesting clinical population because there was no CPT code until 2005, no reimbursement for evaluation, and no efficient method of evaluation. Multiple and complex etiologies exist with a lack of reliable and valid treatments. Patients are noncompliant with suggested treatments, which are usually not reimbursed. A lack of efficient methods to measure treatment outcomes and concomitant medical, social, and psychological components also contribute. MelMedtronics’ TEP offers an additional tool that can assist hearing healthcare professionals in providing care to their tinnitus patients. The TEP will also allow providers to measure treatment outcomes objectively.
Dr. Holmes is the CEO and a senior scientist at MelMedtronics in Colleyville, TX.