Audiology CPT and HCPCS Code Changes for 2021
The following revisions, additions, and deletions to Current Procedural Terminology (CPT ® American Medical Association) and Healthcare Common Procedures Coding System (HCPCS) Level II codes related to audiology services became effective January 1, 2021. There were no major changes to HCPCS device codes for 2021. Audiologists can contact ASHA's health care policy team at reimbursement@asha.org for questions.
For current updates, see audiology CPT and HCPCS code changes for 2023.
New and Revised CPT and HCPCS Codes
The following new and revised CPT and HCPCS codes became effective January 1, 2021.
Auditory Evoked Potential Testing
Four new, more descriptive CPT codes are now available for reporting auditory evoked potential (AEP) testing, replacing CPT codes 92585 (auditory evoked potentials, comprehensive) and 92586 (auditory evoked potentials, limited).
92650 Auditory evoked potentials; screening of auditory potential with broadband stimuli, automated analysis
92651 for hearing status determination, broadband stimuli, with interpretation and report
92652 for threshold estimation at multiple frequencies, with interpretation and report
(Do not report 92652 in conjunction with 92651)
92653 neurodiagnostic, with interpretation and report
ASHA Notes
- These codes represent bilateral testing. Include modifier -52 (reduced service) for unilateral testing.
- Do not report any combination of 92651, 92652, and 92653 together on the same day.
- 92651 describes nonautomated follow-up electrophysiologic testing to rule out significant hearing loss, including auditory neuropathy/auditory dyssynchrony, or to verify the need for additional threshold testing. Testing includes obtaining responses to broadband-evoked auditory brainstem responses (ABRs) using click stimuli at moderate-to-high and low stimulus levels. Don't report 92651 in conjunction with 92652 or 92653.
- 92652 describes extensive electrophysiologic estimation of behavioral hearing thresholds using broadband and/or frequency-specific stimuli at multiple levels and frequencies. 92652 can also include testing with high level stimuli and rarefaction/condensation runs to confirm auditory neuropathy/auditory dyssynchrony. 92652 reflects comprehensive AEP testing for the purpose of quantifying type and degree of hearing loss. Don't report 92652 in conjunction with 92651 or 92653.
- 92653 describes testing to evaluate neural integrity only, without defining threshold. Report this code when the purpose of testing is to identify brainstem or auditory nerve function. 92653 is a less extensive test than 92652 and the basic elements of 92653 are already included in 92651 or 92652 when they are performed to identify and quantify hearing impairment. Don't report 92653 in conjunction with 92651 or 92652.
- Remember to check each payer for policies related to same-day billing with other codes (National Correct Coding Initiative or CCI edits).
Vestibular Evoked Myogenic Potential Testing
Three new CPT codes are now available for reporting vestibular evoked myogenic potential (VEMP) testing. Audiologists previously reported 92700 (unlisted otorhinolaryngological service or procedure) for VEMP testing.
92517 Vestibular evoked myogenic potential testing, with interpretation and report; cervical (cVEMP)
(Do not report 92517 in conjunction with 92270, 92518, 92519)
92518 ocular (oVEMP)
(Do not report 92518 in conjunction with 92270, 92517, 92519)
92519 cervical (cVEMP) and ocular (oVEMP)
(Do not report 92519 in conjunction with 92270, 92517, 92518)
ASHA Notes
- These codes represent bilateral testing. Include modifier -52 (reduced service) for unilateral testing.
- Do not report any combination of CPT codes 92517, 92518, and 92519 together on the same day. Use CPT code 92519 when both cVEMP and oVEMP testing are completed consecutively.
- Remember to check each payer for policies related to same-day billing with other codes (National Correct Coding Initiative or CCI edits).
G-Codes for Virtual Check-Ins and Remote Video/Image Assessment
The following HCPCS G-codes were new for 2021.
G2250 Remote assessment of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, not originating from a related service provided within the previous 7 days nor leading to a service or procedure within the next 24 hours or soonest available appointment
G2251 Brief communication technology-based service, e.g. virtual check-in, by a qualified health care professional who cannot report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to a service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion
ASHA Notes
- Medicare created these new G-codes for use by nonphysician qualified health care professionals who can't bill evaluation and management (E/M) codes, including audiologists. However, Medicare currently doesn't allow audiologists to report these services. For more information on virtual assessments, see Use of Communication Technology-Based Services During COVID-19.
- Current HCPCS codes G2010 and G2012 will remain for providers who can report E/M services.
- Check with state Medicaid programs and commercial insurers regarding coverage of these services.
- To correctly report, these services must be
- initiated by an established patient,
- unrelated to a previous evaluation or treatment session provided within the last seven days,
- conducted through a HIPAA-compliant platform, and
- medically necessary (requires clinical decision making and is not for administrative or scheduling purposes).
- The established patient and HIPAA requirements may be waived by some payers during the public health emergency.
- These services do not replace evaluation or treatment services described by existing CPT codes.
- Documentation of clinical decision making and storage of the exchange are required.
Nonphysician Online Digital Assessment and Management
The following CPT codes are revised for 2021.
98970 Qualified nonphysician health care professional online digital assessment and management, for an established patient, for up to 7 days, cumulative time during the 7 days; 5-10 minutes
98971 11–20 minutes
98972 21 or more minutes
(Report 98970, 98971, 98972 once per 7-day period)
(Do not report online digital E/M services for cumulative visit time less than 5 minutes)
(Do not count 98970, 98971, 98972 time otherwise reported with other services)
ASHA Notes
- These codes, commonly known as "e-visits", are revised from "evaluation and management" to "assessment and management" services provided by nonphysician qualified health care professionals. Coding guidelines and reporting requirements have not changed.
- It is important to check with payers regarding use of e-visit codes. For example, Medicare currently doesn't allow audiologists to report these services. For more information on virtual assessments, see Use of Communication Technology-Based Services During COVID-19.
- To correctly report, an online digital assessment must be
- initiated by an established patient,
- unrelated to a previous evaluation or treatment session provided within the last seven days,
- conducted through a HIPAA-compliant platform, and
- medically necessary (requires clinical decision making and is not for administrative or scheduling purposes).
- The established patient and HIPAA requirements may be waived by some payers during the public health emergency.
- These services do not represent real-time interactions and do not replace evaluation or treatment services described by existing CPT codes.
- Documentation of clinical decision making and storage of the exchange are required.
Deleted CPT and HCPCS Codes
The following CPT and HCPS codes were deleted, effective January 1, 2021.
Auditory Evoked Potentials
92585 Auditory evoked potentials for evoked response audiometry and/or testing of the central nervous system; comprehensive
92586 limited
ASHA Notes
- These codes will be deleted and replaced by four new, more descriptive codes (see above).
- 92585 is replaced by new codes 92652 and 92653.
- 92586 is replaced by new codes 92650 and 92651.
G-Codes for Nonphysician Online Assessment and Management
G2061 Qualified non-physician healthcare professional online assessment and management, for an established patient, for up to seven days, cumulative time during the 7 days; 5–10 minutes
G2062 11–20 minutes
G2063 21 or more minutes
ASHA Notes
- These temporary HCPCS G-codes were created by Medicare to describe online "assessment and management" codes in lieu of existing "evaluation and management" codes.
- Medicare deleted these codes and now uses CPT codes 98720-98972, since they've been revised to describe "assessment and management" services (see above).
See also:
