Tinnitus

Tinnitus Patient Management Program

Thank you for contacting Audiology at UCSF Medical Center. The purpose of this program is to develop a tinnitus management plan designed for your individual needs. It is our belief that tinnitus patients are best served by a comprehensive, multidisciplinary approach.

To ensure that the appropriate diagnostic procedures are completed, we ask that you see an otologist or an ear specialist. If you need a referral to an otologist, call the UCSF Otology Clinic at (415) 353-2757.

We also recommend a consultation with a behavioral health specialist because hyperacusis may have a psychological impact. The behavioral health specialist we commonly work with is Linda Centore, who can be reached at (415) 502-6301.

To help determine if your tinnitus is related to a treatable or a systemic condition, we recommend that you have a complete physical examination including laboratory tests to identify vascular, renal and autoimmune disorders as well as radiologic studies to identify benign growths.

If you have not had an audiological evaluation in the past six months, please notify the receptionist when making your appointment so sufficient time can be scheduled to include this during your appointment here.

Please complete the Tinnitus New Patient Form and Tinnitus Handicap Inventory and fax them to (415) 353-2883 or mail them, along with any audiological records, to our clinic. Once we receive your packet of completed forms, they will be reviewed and you will be contacted to schedule an appointment.

Your Appointment

At your appointment, you will be briefed on the latest information on tinnitus including treatment and management procedures as well as potential advantages and limitations.

Many of these management procedures are not intended to cure tinnitus but are designed to assist you to cope with tinnitus and develop strategies to best adapt to the symptom. The success of any tinnitus management plan depends on your active participation.

Health Insurance

Please be aware that insurance does not cover the cost of tinnitus counseling and management, but may cover associated tests, such as hearing tests and tinnitus matching. The fee for the initial session is about $300. Follow-up counseling ranges from $100 to $200 per visit.

Please obtain written authorization from your insurance company for any recommended test procedures. If your insurance company does not cover any or all of these procedures, or if you have not obtained pre-authorization for each procedure, you will be expected to pay in full at the time of your appointment. These fees do not cover the cost of hearing aids and electronic sound-generating devices.

"Current procedural terminology" (CPT) codes may be required for your insurance authorization for tests performed. The tests — and their CPT codes — that may be performed during your first visit include:

If you have not had a hearing test within the past six months, you may need authorization for the following tests, which would be conducted on an “as needed” basis:

Hearing aids and hearing aid exams are not covered by Medicare and generally not covered by insurance. Hearing aids must be paid for upon receipt. If you have insurance coverage for hearing aids, our financial counselor will be happy to assist you in determining your benefits. Earmolds and electronic sound-generator devices will not be billed to insurance and must be paid for at the time of service.

Please inform the receptionist if you are involved in any legal action. We may not be able to accept you as a patient in these cases.

Management Approaches

Tinnitus is a perception of sound often described as a ringing, buzzing or humming in the ear or head. Usually, though not always, it is accompanied by hearing loss. This symptom affects millions of people. For some, it can be associated with depression, anxiety, sleep disturbance and interference with concentration.

There are many causes for this symptom, including noise exposure, physical injury such as head trauma or whiplash, ear diseases, muscle spasms, circulatory changes, side effects from medication, nerve pathway irritation, central auditory system changes and the aging process. Medical assessment is essential to determine potential causes and treatments.

Approaches to manage this condition include:

• Alternative Treatments
• Amplification
• Biofeedback Training
• Brief Psychotherapy
• Cognitive-Behavioral Therapy
• Dietary Management
• Education
• Habituation Techniques With or Without Sound Generators
• Masking
• Medicine
• Neuromonics Acoustic Desensitization Protocol
• Otologic Consultation
• Pharmacologic Consultation
• Physical Therapy
• Preventive Care Counseling
• Psychological
• Stress Reduction/Management
• Support Group Networks
• Surgery
• Temporomandibular Joint (TMJ) Assessment
• Tinnitus Retraining Therapy

Reviewed by health care specialists at UCSF Medical Center.
Last updated November 17, 2008

This information is for educational purposes only and is not intended to replace the advice of your doctor or health care provider. We encourage you to discuss with your doctor any questions or concerns you may have.