Audiologist vs ENT: Two Professions in Registry and Medicare Data

Physician or not: how federal code lists file the two professions

Federal provider lists keep the two professions apart. In the crosswalk CMS uses to match provider taxonomy codes with Medicare specialties (version of October 2021), the general otolaryngology code 207Y00000X sits under "Allopathic & Osteopathic Physicians" and maps to Medicare specialty 4, "Physician/Otolaryngology". The audiologist code 231H00000X sits under "Speech Language and Hearing Service Providers" and maps to Medicare specialty 64. An ENT (ear, nose and throat physician) is a physician who specializes in otolaryngology; an audiologist is a separately licensed hearing professional.

The Bureau of Labor Statistics sets out the training behind the audiologist title: audiologists need "a doctor of audiology (Au.D.) degree", and "All states require audiologists to be licensed." What an audiologist may do then depends on the state. CMS describes covered audiology as "services furnished by a qualified audiologist as the audiologist is legally authorized to perform under State law (or the State regulatory mechanism provided by State law)."

The same crosswalk gives otolaryngology its own subspecialty codes, such as otology and neurotology or pediatric otolaryngology. The state counts below use the general code only.

Audiologists and ENT physicians by state

The first table counts active individual records in the NPPES file of August 2026, by practice address and primary provider type. On that basis, audiologists outnumber general ENT physicians in each of the 50 states, in the District of Columbia and in Puerto Rico. The size of the gap varies a lot:

• California: 1,557 audiologists and 1,207 ENT physicians, the largest ENT count in the table.
• Texas: 1,473 audiologists and 789 ENT physicians.
• New York: 1,512 audiologists and 765 ENT physicians.
• Louisiana: 249 audiologists for 225 ENT physicians, the closest pair in proportion.
• Colorado: 644 audiologists for 187 ENT physicians, the widest gap in proportion.

Read the counts as a picture of registered practice, not of appointments on offer. A record is self-reported, can outlive the practice it describes and is not a license check. An ENT physician who lists a subspecialty code as primary is not in the column. Hearing instrument specialists, a third registered profession, are compared with audiologists on audiologist vs hearing instrument specialist.

What Medicare pays: a hearing test code next to office visit codes

Medicare covers audiology services as "other diagnostic tests" and pays them under the Physician Fee Schedule, the same schedule that prices office visits. The second table puts the 2026 national amounts side by side, from the CMS file of the October 2026 release:

• 92557, comprehensive hearing test: $35.74 in an office, $25.72 in a facility.
• 99203, office visit for a new patient: $117.57 in an office, $71.48 in a facility.
• 99213, office visit for an established patient: $95.19 in an office, $57.45 in a facility.

The office visit codes run from 99202 ($75.15 in an office) to 99205 ($236.81) for new patients, and from 99212 ($59.45) to 99215 ($192.39) for established ones. They are the schedule's office and outpatient visit codes, not codes reserved for ENT physicians, so the table sets a test next to a visit rather than one profession's price next to the other's. Each amount is national, before the local adjustment Medicare applies, and it is the approved amount, not your share: under Part B "you pay 20% of the Medicare-approved amount" once the deductible is met. Our page on hearing test cost lists every audiology code.

Orders, direct access and the AB modifier

Orders are where the two professions meet in Medicare's rules. CMS says Medicare "requires a physician's order for audiology services in all settings" as its starting point. Then, "for dates of service on or after January 1, 2023, CMS created an exception to the physician order requirement at 42 CFR 410.32(a)(4) to allow patients to directly access audiologists." Once every 12 months, a patient can see an audiologist without an order for certain diagnostic tests the audiologist personally furnishes. The exception covers tests for non-acute hearing conditions, leaves out tests for disequilibrium or imbalance, and billers mark those claims with the AB modifier. Outside it, the order comes from a physician, who need not be an ENT.

Audiologists also bill Medicare in their own name. CMS notes that "audiologists have their own Medicare benefit that allows them to bill for audiology services they personally furnish." The list of codes that can carry the AB modifier, and the exclusions that come with it, are on our page does Medicare cover a hearing test.

What these figures leave out

None of the sources on this page measures skill, waiting times or results, and the page doesn't say which professional to see for a given problem. The counts are registry records, and the amounts are Medicare's national fee schedule: they are not what a clinic charges a patient paying cash, nor what a private plan pays. Private insurers, Medicaid programs and Medicare Advantage plans set their own rules on referrals and audiology visits, so their documents decide. The registry codes and counts for audiologists, fitters and hearing instrument specialists are on audiologist vs hearing instrument specialist.