CMS Proposes Medicare Payment for New Vestibular CPT Codes

The Centers for Medicare & Medicaid Services (CMS) has released the calendar year (CY) 2027 Medicare Physician Fee Schedule (MPFS) proposed rule, which includes proposed Medicare payment for four new Current Procedural Terminology (CPT®) codes describing vestibular diagnostic services.

Beginning January 1, 2027, the CPT code set will include two new codes describing video head impulse testing (vHIT) and two new codes that replace CPT code 92546 for rotational vestibular assessment.

These coding changes were developed through the American Medical Association (AMA) CPT code development and valuation process with input from ASHA and other specialty societies to better reflect current clinical practice and advances in vestibular testing technology.

This update focuses on the new and revised vestibular testing codes and CMS’ associated Medicare payment policies under the CY 2027 MPFS. ASHA is also reviewing the full proposed rule and will provide a broader analysis of other policies that could affect audiologists in the coming days.

Key Takeaways

• Two new CPT codes will describe video head impulse testing (vHIT). CMS accepted ASHA’s recommended values for both codes.
• CPT code 92546 will be deleted and replaced by a new base code and add-on code for rotational vestibular assessment. CMS accepted ASHA’s recommended value for the base code but proposed a lower value than recommended for the add-on code.
• CMS has proposed Medicare payment for the new codes in the CY 2027 MPFS.
• The proposed rule is not final. CMS is expected to publish the final rule later this fall.
• The new CPT codes become effective January 1, 2027.
• Medicaid programs and commercial insurers will establish their own coverage and payment policies and are not required to adopt coding changes or Medicare payment rates.

What Is Changing?

The 2027 CPT changes modernize coding for vestibular assessment by recognizing advances in testing technology and more accurately describing the professional services performed by audiologists.

The changes include:

• two new CPT codes describing vHIT; and
• two new CPT codes replacing CPT code 92546 for rotational vestibular assessment using sinusoidal harmonic acceleration (SHA) testing and velocity step testing (VST).

Together, these revisions expand and modernize the vestibular CPT code family while better aligning code descriptors with current clinical practice.

Proposed Medicare Payment

The table below summarizes the proposed national Medicare Part B payment estimates based on CMS's proposed conversion factor of $33.5875. These proposed estimates apply only to services paid under the MPFS, are subject to change in the final rule, and may vary based on geographic locality and other Medicare payment adjustments.

Medicaid programs and commercial health plans establish their own payment policies and are not required to adopt Medicare payment rates.

CMS did not publish RVU information for three of the four new codes. ASHA has requested clarification and a correction from CMS.

What Happens Next?

The proposed rule is currently open for public comment through September 14, 2026. ASHA is reviewing the proposal and will submit comments to CMS as appropriate before the public comment deadline.

Over the coming months, ASHA will continue to:

• provide updates on the Medicare rulemaking process;
• develop coding and billing resources for the new vestibular CPT codes;
• educate audiologists on appropriate code selection and documentation; and
• work with Medicare, Medicaid, and commercial payers to support implementation of the new code set.

CMS is expected to publish the final MPFS later this fall. The official CPT code numbers will be published in the 2027 CPT Professional Edition before the January 1, 2027, implementation date.

Questions?

Contact ASHA’s health care and education policy team at reimbursement@asha.org.