Coding and Billing of Hearing Device-Related Services

Effective January 1, 2026, a set of 12 new Current Procedural Terminology (CPT®) codes replaced the outdated legacy codes (92590–92595) describing hearing device-related services. This implementation of the new hearing device services codes represents a significant advancement in how audiologic services are described and reported. The new framework aligns with the Evaluative and Therapeutic Services section of the CPT manual, providing flexibility for clinical judgment and individualized patient management.

Unlike the Audiologic Function Tests section—diagnostic audiologic testing codes 92550-92596—which precisely define required procedures, the new codes are more descriptive. They acknowledge that professional audiologic care involves varying combinations of assessment, counseling, verification, and follow-up, depending on the patient’s unique needs. As a result, these new codes are descriptive and not prescriptive in nature, allowing clinicians greater flexibility to determine what services would be most appropriate under each code. Therefore, the long descriptor of each code may not fully describe every single element of the services that could be provided. Alternatively, not all services under the long descriptor must be provided in order to report the code.

For additional information on the new code set, including educational webinars, see: New Hearing Device Services Codes: Modernizing Audiologic Services and Audiology CPT and HCPCS Code Changes for 2026

On this page:

• Valuation and Payer Adoption
• Impact on Clinical Practice and Unbundled Models
• Relationship With HCPCS Codes (V Codes)
• Overview of the New Code Structure
  • Candidacy and Selection
  • Fitting and Post-Fitting
  • Verification and Assistive Devices
• Coding and Billing Considerations
  • Cochlear Implant and Auditory Osseointegrated Devices
  • Time-Based Documentation and Minimum Requirements
  • Same-Day Testing for Hearing Loss and Hearing Aid Candidacy/Selection
  • Billing & Coding Scenarios

Valuation and Payer Adoption

The legacy codes 92590–92595 were retired on January 1, 2026. However, some payers may continue to reimburse these codes following January 1, 2026, until they fully transition to the new codes. Clinicians should verify directly with the payer which codes are to be reported.

These codes currently have no assigned Relative Value Units (RVUs) and are subject to carrier pricing. This mirrors the legacy codes, which were also not statutorily covered under Medicare. Payment will therefore depend on individual payer policy and provider contracts.

Medicare excludes hearing aids and related services from coverage, but Medicaid, Medicare Advantage and commercial insurers may elect to reimburse them.

For hospital or institutional settings using productivity measures tied to RVUs, time-based tracking may assist in quantifying workload and service volume.

Impact on Clinical Practice and Unbundled Models

For practices that unbundle professional hearing aid services, these codes allow for greater transparency and alignment with the actual clinical effort involved. The descriptors more accurately reflect the full range of evaluative and therapeutic activities audiologists perform, including counseling, validation, and verification.

Although payers will ultimately determine reimbursement policies, the adoption of standardized CPT codes offers a consistent foundation for the recognition of audiologists’ professional work. Payer and institutional education remain critical to ensure accurate and fair compensation.

See also: Unbundling Hearing Aid Sales

Relationship With HCPCS Codes (V Codes)

The introduction of the new CPT codes does not change or eliminate existing HCPCS Level II codes that describe devices and some services not captured in the CPT code set (e.g., V codes). These V codes remain in use for billing devices and associated fees, such as ear impressions or dispensing. For example, V5160 (dispensing fee, binaural) continues to apply when billing for physical devices. A clinician may report the V codes in conjunction with CPT codes to report for hearing aids and other products. However, if audiologists choose to report a service using a V code, which could be reported under the CPT codes, then the time spent performing that service reported under the V code may not be counted towards the CPT code. For example, ear mold impression may be reported using V code (V5275) or under 92631/92632. However, when earmold impressions are reported separately using the V code (V5275), the time spent performing the earmold impression should not be counted toward timed code 92631/92632.

If the hearing device services encounter does not meet the minimum threshold to report a timed code (half of the time on the code descriptor +1 minute or the 51% rule), then a clinician could use the V code to report the services performed.

For CROS/BiCROS and bone conduction devices, the appropriate V code may be selected unless the payers require audiologists to report hearing device selection-related CPT codes for CROS/BiCROs devices. 

See also: Codes for Contralateral Routing Hearing Devices Change in 2019: New and revised codes provide greater reporting flexibility, but payers may be slow to implement them

The new CPT codes are intended solely for professional services, such as evaluation, selection, fitting, and follow-up. Payers may choose whether to reimburse these services under CPT or continue using V codes depending on their policy. Some programs, such as state Medicaid plans, may continue to require V code usage for unbundled hearing device services.

Overview of the New Code Structure

The new code set includes 12 CPT codes describing the full continuum of hearing device services:

1. Candidacy Evaluation (92628–92629)
2. Device Selection (92631–92632)
3. Fitting and Follow-Up (92634–92637)
4. Verification and Assistive Device Services (92638–92642)

This structure provides a more comprehensive representation of the care process, recognizing the multifaceted nature of hearing device management.

The use of these codes applies to patients whose audiometric results suggest that an air conduction hearing aid may be the most appropriate option for the treatment of sensorineural, mixed, and conductive hearing loss. Following a diagnosis of hearing loss, this set of codes would apply to the full range of services specific to air conduction hearing devices. If the results indicate thresholds within normal limits but the patient reports hearing difficulties not reflected on the audiogram, these codes allow for additional testing to determine whether hearing aid treatment is warranted. These codes may not be used when assessing for conditions such as tinnitus or misophonia, even though the outcome of the evaluation may be recommending management with a hearing aid. 

Candidacy and Selection Services

These codes include candidacy determination and hearing device selection. They recognize varying practice patterns and allow for flexibility in code selection.

When the results of the comprehensive audiometry threshold evaluation (92557) indicate the audiometric need for air conduction hearing devices, audiologists proceed with the candidacy evaluation. The candidacy codes (92628-92629) describe evaluation of hearing aid appropriateness, including but not limited to review of audiologic results, speech-in-noise testing, suprathreshold measures, counseling, and assessment of cognitive-communication status when performed along with candidacy evaluation. The time designation in the code descriptor also includes the time generating the report. A patient may or may not pursue amplification on the same day during the candidacy evaluation. The candidacy codes may be reported when the patient does not move forward with the recommendation on the same day as the assessment.     

The selection codes (92631-92632) include the review of hearing results, candidacy determination, selection of technology, style, color of device, as well as assessment of patient-specific factors like lifestyle, dexterity, visual ability, and psychosocial considerations. The selection code may be reported when the patient elects to move forward with a hearing device. This service may occur on the same date of service, during the same encounter as hearing assessment and candidacy evaluation, or on a different date of service. For example, a patient may come from a different facility having already gone through the evaluation and candidacy or returning on a different day after their initial evaluations, ready to move forward with a previous recommendation for treatment.

Candidacy and selection codes cannot be billed on the same date of service. If the patient elects amplification during the same encounter, the selection code should be reported, accounting for total time for both evaluation and selection. 

Fitting and Post-Fitting Services

These include the work of fitting hearing devices and follow-up services provided after the fitting.

The hearing aid fitting codes (92634-92635) represent the comprehensive encounter in which hearing aids are analyzed, programmed, and verified, and the patient is oriented and counseled on device use. Pre-fitting activities, such as device ordering or pre-programming, are considered part of practice administrative burden, not separately billable under a CPT code. Hearing aid fitting services (92634–92635) should not be reported in conjunction with post-fitting follow-up services (92636–92637), as the follow-up codes are intended to be reported during separate encounters that occur after the initial fitting service.

The hearing aid post-fitting follow-up codes (92636-92637) include activities such as device verification, adjustment, validation of benefit, and counseling. When follow-up visits extend beyond 38 minutes, the additional 15-minute add-on code may be added. Post-fitting services are provided on a separate date when the patient returns after the initial hearing aid selection and fitting services have been completed. Accordingly, post-fitting services (CPT codes 92636–92637) should not be reported on the same date of service as candidacy evaluation, selection services, or fitting services.

Hearing assistive device and/or supplemental technology services described by CPT code 92642 should not be reported on the same date of service as hearing aid fitting or post-fitting services, as these services are already included in CPT codes 92634–92637. Reporting these codes together would be considered unbundling of services.

For services, such as cleaning or adjustments without orientation, the post-fitting follow-up code may be reported. These encounters document continued patient management rather than diagnostic testing. If the encounter minimum threshold (half of the time on the code descriptor + 1 minute) for billing the timed codes, then a clinician may use the V code for hearing aid repair (V5014) or miscellaneous hearing aid service (V5299).

Codes 92628, 92629, 92631, 92632, 92634, 92635, 92636, 92637, and 92638 describe unilateral or bilateral services. These codes do not need to be appended with modifiers such as modifier-52 for reduced service or -LT/RT or indicate laterality unless specified by the payer.

Verification and Assistive Device Services

These four codes describe additional assessments that require specialized equipment. The verification codes (92638-92641) were created to capture the specific types of verification that may be completed as part of the fitting and follow-up process (92634-92637). CPT codes 92638 and 92639 are untimed add-on codes to be reported in conjunction with fitting or follow-up codes. They cannot be reported separately. CPT codes 92641 and 92642 are untimed standalone codes that may be reported separately.

Verification codes capture objective measures used to confirm hearing aid performance and patient benefit. Objective verification is typically performed either at the time of fitting or post-fitting follow-up, and it can be performed through behavioral verification, probe-microphone measurement, and/or electroacoustic analysis as appropriate.

Codes 92638, 92639, and 92641 represent three different methods of objective verification and may be reported concurrently with 92634, 92635, 92636, and 92637.

Behavioral Verification (92638): This code includes aided thresholds, functional gain, or speech-in-noise testing when performed. Providers do not need to complete all components described in the code descriptor but must document the method(s) chosen and results obtained. This code describes unilateral or bilateral services; therefore, 92638 does not need to be appended with modifiers (e.g., modifiers 52 or LT/RT). 92638 is an untimed add-on code that can be reported in conjunction with CPT codes 92634 and 92635 (fitting services) or 92636 and 92637 (post-fitting services), when provided on the same date of service. Time spent performing behavioral verification should be reported separately and should not be included in the time reported for fitting or post-fitting services under these timed codes.

Probe-Microphone Verification (92639): This code is used for real-ear measurements (REM), speech mapping, or real-ear-to-coupler difference. This untimed add-on code may also be appropriate to report for simulated real ear measurement (SREM) and real-ear-to-coupler difference (RECD) when these services are performed on the same date of service as hearing aid fitting or follow-up services. Although part of the verification occurs in the test box, RECD is fundamentally a probe-microphone-based verification, as it is not considered electroacoustic analysis (EAA) as listed below. EAA focuses on confirming device function against manufacturer specifications, while 92639 reflects evaluating how the hearing aid is programmed to perform on that patient’s ear(s). As the code descriptor describes, the probe-microphone verification must be performed to report this code. Time spent performing probe-microphone verification should be reported separately and should not be included in the time reported for fitting or post-fitting services under these timed codes.

Electroacoustic Analysis- EAA- (92641): This code is used to verify hearing aid or assistive device function, including quality control. This may be reported independently or alongside fitting and follow-up codes. Hearing assistive technology (HAT) verification may be reported under this code if the clinicians are using the EAA text box equipment. 92641 may be reported when running SREM with Average RECDs as these test box measures would be considered as electroacoustic analysis. If these services are performed on the same day, clinicians may report both 92639 and 92641.

Electroacoustic analysis verification (92641) can be performed by itself or with other types of hearing devices, such as frequency modulated/digitally modulated technology or auditory osseointegrated devices (AOD).

Codes 92639 and 92641 represent services performed on both ears, and modifier 52 must be appended if the service is only performed on one ear. Therefore, for unilateral services, use modifier 52 and/or laterality modifier LT/RT as appropriate.

Hearing Assistive Device Fitting (92642): This code describes fitting services for hearing assistive supplemental technology and is reported for verification of personal FM/DM systems and fitting services for hearing assistive supplemental technology.

Verification activities performed during fittings or follow-ups may be reported separately, as these procedures have distinct CPT codes and that time is not counted toward the primary service.

Coding and Billing Considerations

Cochlear Implant (CI) and Auditory Osseointegrated Devices (AOD)

The new hearing device services CPT codes apply to air conduction hearing aids and hearing assistive technology. The only exemption to reporting hearing device services codes would be with electroacoustic analysis verification (92641) for AODs. Otherwise, for implantable or softband AODs, existing codes remain appropriate:

• Codes 92601 and 92603 describe post-operative analysis and fitting of previously placed external devices, connection to the CI, and programming of the stimulator. Codes 92602 and 92604 describe subsequent sessions for measurements and adjustment of the external transmitter and re-programming of the internal stimulator.
• Codes 92622 and 92623 describe the analysis, programming, and verification of an AOD sound processor of any type. These services include evaluating the attachment of the processor, device feedback calibration, device programming, and verification of the processor performance. These codes should be used for subsequent reprogramming when performed.

However, when a patient uses a hearing aid on the contralateral ear, the new CPT codes may be reported on the same date of service for that ear. In this case, the RT/LT modifiers should be included.

The evaluation to determine whether a patient is a candidate for an implant, such as a bone anchored hearing aid (BAHA), would be reported as 92626/27. That evaluation includes the AOD and CROS/BiCROS comparison. Even though the outcome of the evaluation may be the CROS (or BiCROS) aid, the evaluation is for the purpose of determining the suitability of an AOD.

For programming or troubleshooting an AOD—for example, a softband BAHA—the audiologist would use CPT codes 92622/92623. The description indicates "any type," which covers the alternative softband or surgical abutment of the BAHA.

See also: Audiology CPT and HCPCS Code Changes for 2024 

Time-Based Documentation and Minimum Requirements

CPT codes 92628–92637 are primarily time-based, and each code defines the specific time associated with each base code and includes add-on codes for additional 15-minute increments.

Objective verification measures (behavioral, probe-microphone, and electroacoustic analysis) are untimed codes (92638–92639) that can be reported alongside fitting or follow-up codes as add-on codes. CPT codes 92641 and 92642 are untimed standalone codes that may be reported separately for verification services as appropriate.

The -52 modifier (reduced service) cannot be used for time-based codes under any circumstances, including when only individual elements of the descriptor are completed or to bypass minimum time requirements. Codes 92639 and 92641 represent services performed on both ears, and modifier -52 must be appended if the service is only performed on one ear. A laterality modifier, -RT/-LT, may also be required for some payers. 

Documentation should clearly describe the services rendered and time spent to minimize claim denials, as accurate documentation is fundamental to compliance. Start and stop times alone are insufficient; providers must also record a clear description of total time spent and the activities performed. Recommended documentation language includes:

Each time-based code has a minimum duration threshold that must be met before it can be billed. Timed code requirements follow the “half plus one” or “51%” rule. The American Medical Association CPT 2026 Professional Edition indicates that “a unit of time is attained when the mid-point is passed. For example, an hour is attained when 31 minutes have elapsed (more than midway between zero and 60 minutes). The ‘time’ is the time spent face-to-face with the patient”. Add-on codes apply once the full-time requirement for the base code has been exceeded. For example, a clinician must provide the entire 30 minutes (up to 37 minutes) for 92636 prior to start billing the add-on code 92637.

The two untimed verification codes, 92638 and 92639, may be billed together with 92634/92635 or 92636/92637 once the minimum requirements of the base code (or add-on code, if billed) have been met. When billing 92638 and 92639, the full-time requirement for the base code (92634/92636) does not need to be fulfilled. For example, a clinician may report one unit of 92636 once they have reached 16 minutes and then report 92638.

Codes 92638, 92639, 92641, and 92642 are not time-based, and their completion depends on the performance of the specific verification or assistive fitting procedure. As untimed codes, they do not require audiologists to document the exact amount of time spent performing these services.

Payers may impose specific Medically Unlikely Edits (MUEs) policies that dictate how many units of these timed codes can be billed on the same date of service. Audiologists should be familiar with the MUEs for each code prior to billing. Timed codes generally have an MUE greater than “1” and can be reported in multiple units to capture the time spent. However, an untimed code has an MUE of “1” and can be reported only once per date of service, regardless of the length of the procedure.

See also: Medically Unlikely Edits for Audiology Services

Audiologists cannot use these CPT codes to bill for time spent on activities such as administrative tasks, pre-programming hearing aids, ANSI testing, or situations where a device is simply dropped off as these codes require face-to-face patient encounters. However, if pre-programming is completed on the date of the patient encounter, the electroacoustic analysis code may be billed.

Administrative time such as unpacking or packing devices, ordering, or boxing hearing aids cannot be billed. For hearing aid drop-off situations, clinicians may bill the appropriate V codes, when permitted by the payer, based on the service provided (e.g., V5014 for repairs or V5299 for miscellaneous hearing aid services).  

The following table elaborates on the minimum time threshold defined for each code to justify billing.

See also: The Right Time for Billing Codes: Here’s what you need to know about billing timed and untimed evaluation and procedure codes.  

Same-Day Testing for Hearing Loss and Hearing Aid Candidacy and Selection

Evaluation for hearing loss (92550–92588) may be performed and billed on the same day as candidacy evaluation and/or selection services as appropriate, when payer policy permits. For example, 92557 may be reported on the same day as 92628/92631 if permitted by payer policy and National Correct Coding Initiative (CCI) edits.

See also: CCI Edit Tables for Audiology Services

Billing & Coding Scenarios

Please note that the following examples are provided for illustrative purposes only and may not apply to every scenario. This code set is descriptive in nature rather than prescriptive; therefore, the examples are intended solely to support understanding and offer guidance in relevant situations but should not be generalized.

Example of reporting 92628 and 92629 for evaluation for hearing aid candidacy:

An established patient with a history of mild to moderate high frequency sensorineural hearing loss is seen in an audiology clinic. The patient utilizes over-the-counter (OTC) hearing aids and reports experiencing more hearing challenges in certain settings. The audiologist reviews the results of recently obtained measurements which include tympanometry, comprehensive audiometry, speech in noise testing (+3dB SNR Loss), and the Hearing Handicap Inventory for Adults (mild to moderate handicap (22%) for Social and (4%) for Emotional). The audiologist summarizes the results of each test as they relate to communication and counsels the patient that the current hearing loss and communication difficulties can be addressed by either a prescription hearing aid or an OTC device that can be adjusted to current thresholds. The audiologist provides a summary chart to the patient which documents testing findings and outlines the patient’s option of adjusting the current OTC devices or pursuing prescription hearing aids and optional hearing aid compatible assistive technology. The total time for the appointment was 49 minutes.

 Example of reporting 92631 and 92632 for hearing aid selection services:

A 72-year-old patient with bilateral mild to moderate sensorineural hearing loss is seen for hearing aid selection, accompanied by their spouse, following a recent audiologic and hearing aid evaluation at an outside clinic. The appointment begins with an informal conversation aimed at gauging the patient’s motivation to improve their communicative abilities as well as the level of support present from their communication partner—in this case, their spouse. The audiologist then administers a Client Oriented Scale of Improvement (COSI) to determine the patient’s communication needs and goals for amplification. The audiologist assesses the patient’s visual and manual dexterity by having them handle various demo hearing aids. The patient and the audiologist determine that due to some fine motor limitations, a rechargeable behind-the-ear style hearing aid is likely most appropriate. They discuss signal processing features and connectivity options in the context of the patient’s communication needs and select mid-level technology with embedded Bluetooth connectivity. The audiologist answers the patient’s questions about the fitting process and provides a formal report documenting the findings and recommendations. The patient will return in two weeks for their hearing aid fitting appointment. The appointment lasts for 54 minutes.

 Example of reporting 92634 and 92635 for fitting and follow-up services:

A 72-year-old patient completed her hearing aid selection appointment and is returning to the office for a fitting of her bilateral, in-the-ear (ITE) hearing aids. The audiologist reviews with the patient how to distinguish the right and left devices, how to insert and remove the hearing aids, and how to clean the devices. Probe microphone measures are completed to approximate the prescriptive target for soft, average, and loud input levels. During probe microphone measurements, the patient’s hearing aids are connected to the hearing aid fitting software and programmed accordingly. The audiologist then reviews realistic expectations of hearing aids based on her specific hearing loss, use of the devices, and has the patient practice changing her hearing aid batteries in the office. They also review storage of the hearing aids and device batteries. The audiologist discusses the warranty and trial period with the patient, and she is scheduled to return for a hearing aid follow-up in two weeks.  The total time for the appointment was 49 minutes.

Example of reporting 92636 and 92637 for hearing aid post-fitting follow-up services:

A 68-year-old patient is returning to see her audiologist for a two-week post-hearing aid fitting follow-up appointment. She reports that the physical comfort of the receiver cable feels too snug. She also notes that she feels certain speech sounds are too loud. The audiologist connects the hearing aids to the programming software and reads out the data log, which shows that the patient has only worn the hearing aids a total of four hours in the past two weeks. Additionally, the audiologist watches the patient insert and remove the hearing aids in the office and notices that the receiver cable may be too short. The audiologist changes the receiver cable to a longer length to improve comfort. The audiologist makes minor programming adjustments and counsels the patient regarding their low use time. The audiologist and patient come up with goals for hearing aid use moving forward, including increased wear time per day. The total time for the appointment was 42 minutes.

Example of reporting 92638 for behavioral verification services:

A patient was fit with hearing aids to address bilateral profound hearing loss. The patient returns for a hearing aid fitting service and expresses uncertainty over some of the benefits of a hearing aid. The audiologist performed speech mapping at the initial fitting, and the device is programmed appropriately. The audiologist opts to perform aided and unaided sound field testing in quiet and in noise and validates patient benefits and performance. This appointment lasts 55 minutes—34 spent on hearing aid fitting service and 21 spent on behavioral verification services.

Example of reporting 92639 for hearing aid verification with probe microphone:

A 70-year-old patient returns for post-fitting follow-up services and reports they cannot hear well and feels speech, especially children's voices, is difficult to hear. The audiologist performs probe microphone measurements to look at the current settings for soft, average, and loud input levels. These measurements reveal that the hearing aids’ output is significantly below target for soft and average speech inputs, especially in the high frequency range, which is likely resulting in the patient’s reports of inaudibility. Without this verification, the under-amplification would have gone unnoticed, and the patient might have become dissatisfied and possibly discontinued hearing aid use. By adjusting the hearing aids based on real-ear results, the audiologist verifies the amplification meets prescriptive targets. Afterward, the patient reports that understanding their grandchildren's voices has much improved following the reprogramming. This appointment lasts 58 minutes, with 32 minutes on post-fitting services and 26 minutes on hearing aid verification.

Example of reporting 92641 for hearing assistive device services, electroacoustic analysis:

An individual comes into an audiology clinic with hearing aids and reports that their left hearing aid is giving them a low battery indicator every day and is not performing as well as the hearing aid in their right ear. The patient also mentions when there is a loud sound, the hearing aid gets a mechanical sound quality leading to sound distortion, then returns to normal after a few moments. The provider decides to run electroacoustic analysis (EAA) on the hearing aids to assess the devices’ functionality, specifically looking at the measurement of distortion at any of the frequencies tested and battery drain. Based on the patient report of issues when loud sounds are present, output verification is also measured through EAA to assess the hearing aid’s maximum output (OSPL90) to ensure it is not exceeding safe levels. Running EAA prevents unnecessary reprogramming and ensures any hardware issue is addressed first. This appointment lasts 40 minutes.

Example of reporting 92642 for hearing assistive device, supplemental technology fitting services:

A 3-year-old child with severe bilateral sensorineural hearing loss is seen in the audiology clinic for fitting and orientation of a remote microphone system for personal use (outside of preschool). The child currently wears binaural behind-the-ear style hearing aids with embedded receivers. During the appointment, the remote microphone system was paired to the child’s hearing aids and audibility was verified through a listening check. The audiologist provides training to the parents on proper use, charging, and troubleshooting of the equipment. The audiologist documents the fitting and schedules a one-month follow-up appointment to collect outcome measures. This appointment will take 39 minutes.