Audiology Assistant Supervision

This page provides highlights from the Scope of Practice for Audiology Assistants and includes information on

Supervisor Qualifications
Frequency and Amount of Supervision
Expectations of the Supervising Audiologist
Billing and Reimbursement
Ethical Considerations
Resources

Supervisor Qualifications

ASHA recommends the following minimum qualifications for an audiologist who will supervise an audiology assistant:

Holds current ASHA certification and/or current state licensure.
Has the equivalent of 9 months of full-time clinical practice after being awarded certification.
Has completed 2 hours of professional development in the area of supervision.
Has an active interest in the use of and desire to use support personnel.

Frequency and Amount of Supervision

The supervising audiologist is responsible for designing and implementing a supervisory plan ensuring that the highest standard of quality care can be maintained for patients/clients/students. Supervision requirements can vary based upon a variety of factors. The amount and type of supervision should meet the minimum requirements according to state regulations and should be increased as needed based on (a) the needs, competencies, skills, expectations, philosophies, and experience of the audiology assistant and their supervisor; (b) the needs of the patients/clients/students served; (c) the service setting; (d) the tasks assigned; and (e) other factors.

Types of supervision may vary. The most used supervision types are described below.

Direct supervision – on-site observation and guidance while an audiology assistant is performing a clinical activity. This direct supervision can include the supervising audiologist viewing and communicating with the audiology assistant via telecommunication technology as the audiology assistant provides clinical services—because this situation allows the audiologist to provide ongoing, immediate feedback.

Direct supervision does not include reviewing a recorded session at a later time. Payers and state licensure laws may require different levels of supervision and should be consulted prior to initiating services provided by an audiology assistant to ensure compliance with these policies and eligibility for reimbursement.

Indirect supervision – a supervisory style in which the audiologist is not physically located at the same facility or in close proximity to the audiology assistant but is available to provide supervision by electronic means. Indirect supervision activities performed by the supervising audiologist may include, but may not be limited to, demonstration, record review, review, and evaluation of recorded (audiotaped or videotaped) sessions, and interactive television and supervisory conferences that may be conducted by telephone, email, or live webcam. Indirect supervision can also be described as asynchronous supervision.

Expectations of the Supervising Audiologist

Regularly conducts ongoing competency evaluations of audiology assistants as required by the work setting.
Provides and encourages ongoing education and training opportunities for audiology assistants consistent with competency and skills as well as needs of the patients/clients/students served.
Develops, reviews, and modifies plans of care for patients/clients/students that audiology assistants implement under the audiologist’s supervision.
Adheres to the supervisory responsibilities of audiology assistants.
Retains the legal and ethical responsibility for all patients/clients/students served.
Adheres to the principles and rules of the ASHA Code of Ethics and/or state licensure.
Adheres to applicable licensure laws and rules regulating the practice of audiology.

Billing and Reimbursement

Supervision requirements of audiology assistants can vary by state, payer, and setting. It is important to consider all applicable requirements to ensure that you are billing for services provided by assistants appropriately. The final authority on billing and payment requirements is the patient's insurance plan (payer), in compliance with state law. For more information on supervision requirements across payers, see Supervision of Assistants: Billing and Payment Compliance.

Ethical Considerations

It is imperative that the supervising audiologist and the assistant behave in a manner that is consistent with the principles and rules outlined in state licensure and in the ASHA Code of Ethics as applicable. The audiologist or hearing scientist takes overall responsibility for the actions of the assistant when they (the assistant) are performing assigned duties. If the assistant engages in activities that violate the ASHA Code of Ethics, then the supervising audiologist may be found in violation of the code if it is found that adequate oversight has not been provided. The ASHA Assistants Code of Conduct outlines the standards of integrity and the expected ethical conduct of audiology assistants.