To refer a patient who has Medicare, please write a prescription for Audiologic Evaluation, including the diagnosis under consideration.
Fax to (310) 206-2331 with all pertinent medical records including past audiological evaluations.
To refer an HMO patient, please submit an authorization for CPT codes 92557 and 92550 for adults and children over the age of 5.
For children ages 6 months to 3 years, please submit authorization for CPT codes 92579, 92587 and 92550.
For children ages 3-5 years please submit for CPT codes 92582, 92587, and 92550.
If you have questions please call (310) 825-5721.
Your patient will need a prescription to initiate services. You may send the Rx to us in one of the following ways:
Speech Pathology Clinic
200 UCLA Medical Plaza, Suite 560
Los Angeles, CA 90095-6955
If you have any questions in regard to the services offered, please call us at (310) 825-8551.