A Guide to Mandatory Medicare Enrollment for Audiologists and SLPs in Private Practice

December 5, 2025

Audiologists and speech-language pathologists (SLPs) in private practice who want to work with Medicare patients must enroll in Medicare. Unlike some other health care providers (like physicians), audiologists and SLPs cannot "opt out" of Medicare or enter into private pay arrangements with Medicare patients.

If audiologists and SLPs provide services to Medicare patients without enrolling in Medicare, they must repay the patient for any covered services provided-and in some cases, they may face additional financial penalties. If an audiologist or SLP doesn't want to enroll in Medicare, their only option is to turn Medicare patients away.

In order to help our members maintain compliance, ASHA has developed a detailed resource as well as an enrollment guide that walks through the Medicare enrollment process.

Advocating for Patient Choice

ASHA also understands that Medicare enrollment can cause problems for many clinicians. For example, many Medicare beneficiaries have an established relationship with an audiologist/SLP through their employer-sponsored health insurance. But when they retire, they discover that clinician doesn't accept Medicare, so the patient can no longer access the clinician's services. Medicare payment cuts and uncertain telehealth coverage also make it difficult for clinicians to keep their practices financially stable.

That's why ASHA supports the Medicare Patient Choice Act (H.R. 4204). This bill would allow audiologists, physical and occupational therapists, and SLPs to do what other health care providers already do: give Medicare patients the flexibility to see the clinicians of their choice regardless of whether that clinician has enrolled with Medicare.

Take Action

ASHA's Take Action page is a great way to contact your members of Congress and urge them to support the Medicare Patient Choice Act. You can also join ASHA in advocating against Medicare payment cuts and in support of permanent telehealth authority for audiologists and SLPs.

ASHA Advocacy is here to help members understand their compliance obligations and to partner with them to identify solutions that enable them to treat their patients.

Questions?

Please email [email protected] for questions about mandatory enrollment and claims submission under Medicare.

Please email [email protected] for questions regarding advocacy in support of the Medicare Patient Choice Act.