AAO16: Age-Related Hearing Loss: Comprehensive Audiometric Evaluation+

Download PDF

High Priority Status: Yes / Care Coordination

CBE Number: N/A

Measure Description:

Percentage of patients aged 50 years and older who failed a hearing screening and/or who report suspected hearing loss who received, were ordered, or were referred for comprehensive audiometric evaluation within 4 weeks of the office visit.

Instructions:

This measure is to be submitted a minimum of once per performance period for patients seen for suspected/unspecified hearing loss during the performance period. This measure may be submitted by clinicians based on the services provided and the measure-specific denominator coding.

Denominator:

All patients aged 50 years and older who failed a hearing screening and/or who report suspected hearing loss

Denominator Note:

To meet the denominator criteria, a patient must present with first time hearing difficulties or hearing difficulties are suspected, or unspecified hearing loss. Patients with a confirmed diagnosis of hearing loss are excluded from this measure.

Denominator Exclusions:

None

Denominator Criteria:

Patients aged 50 years and older

AND

Failed a hearing screening

AND/OR

Reported suspected hearing loss

For a list of codes that qualify as denominator eligible visits, reference Addendum attached.

Numerator:

Patients who received, were ordered, or were referred for comprehensive audiometric evaluation* within 4 weeks of the office visit

*Comprehensive audiometric evaluation: The hearing evaluation should include a physical examination of the patient’s ears and an evaluation of the patient’s hearing acuity using an audiometer in a sound booth. The hearing evaluation may include the use of pure tone audiometry, bone conduction hearing testing, Hearing in Noise Test, speech tests, acoustic reflex test, auditory brainstem response testing (e.g. when patient is not able to complete behavioral audiometry) or other appropriate hearing evaluation tests.

Numerator Note:

To meet the intent of the measure, the numerator quality action must be performed during or within 4 weeks of the encounter in which suspected hearing loss is documented

Denominator Exceptions:

Medical reason(s) for not evaluating for hearing loss include patients who had an audiogram within last year; patients with an active diagnosis of deafness, hearing impairment, head or ear trauma, history of other hearing impairment. Patient refusal.

Measure Classifications:

• Submission Pathway: Traditional MIPS, MIPS Value Pathways (MVP)
• Measure Type: Process
• High Priority Type: Care Coordination
• Meaningful Measures Area: Preventive Care
• Care Setting(s): Ambulatory Care: Clinician Office/Clinic
• Includes Telehealth: Yes
• Number of Performance Rates: 1
  • Inverse measure: No
  • Continuous measure: No
  • Proportional measure: Yes
  • Ratio measure: No
  • Risk Adjusted measure: No

Clinical Recommendation Statement:

The objective of auditory assessment is to diagnose the type and magnitude of hearing loss and the need for treatment including candidacy for amplification. As a result of the audiologic assessment, the patient may be referred for additional services (e.g., electrophysiologic tests, medical or surgical intervention, etc.). The prerequisites leading to the hearing aid fitting process should include a comprehensive case history, otoscopic inspection, cerumen management, hearing assessment, and needs assessment.

American Speech-Language-Hearing Association. Adult Hearing. http://www.asha.org/Practice-Portal/Professional-Issues/Adult-Hearing-Screening/. Access 2018.

Valente M, Abrams H et al. Guidelines for the Audiologic Management of Adult Hearing Impairment. Audiology Today. 2006. 18(5); 1-44.

 Rationale:

Approximately one-third of persons over 65 years are affected by disabling hearing loss. Despite its prevalence and morbidity, hearing loss is underrecognized and undertreated. Undertreatment may lead to declined quality of life and exacerbation of social isolation, depression, and even cognitive decline.

Rutherford BR, Brewster K, Golub JS, Kim AH, Roose SP. Sensation and Psychiatry: Linking Age-Related Hearing Loss to Late-Life Depression and Cognitive Decline. The American journal of psychiatry. 2018;175(3):215-224. doi:10.1176/appi.ajp.2017.17040423

Supporting Clinical Practice Guideline (CPG):

For more details, reference the Clinical Practice Guideline: Age-Related Hearing Loss (2024)

© 2026 American Academy of Otolaryngology–Head and Neck Surgery Foundation. All rights reserved.

Limited proprietary coding is contained in the measure specifications for convenience. Users of the proprietary code sets should obtain all necessary licenses from the owners of these code sets. The measures, while copyrighted, can be reproduced and distributed, without modification, for noncommercial purposes, e.g., use by health care providers in connection with their practices. Commercial use is defined as the sale, license, or distribution of the measures for commercial gain, or incorporation of the measures into a product or service that is sold, licensed or distributed for commercial gain. Commercial uses of the measures require a license agreement between the user and the American Academy of Otolaryngology – Head and Neck Surgery Foundation.

The measure is not a clinical guideline, does not establish a standard of medical care, and has not been tested for all potential applications. The measure and specifications are provided “as is” without warranty of any kind. Neither the American Academy of Otolaryngology – Head and Neck Surgery Foundation (AAO-HNSF), nor its members shall be responsible for any use of the measure. The AAO-HNSF and its members disclaim all liability for use or accuracy of any Current Procedural Terminology (CPT®) or other coding contained in the specifications.

Addendum