2025 HCPCS code V5010
(Active) Effective Date: N/A Revision Date: N/A Audiology - Hearing Aid Assessment Hearing Assessments and Evaluations Feed
Assessment for hearing aid; evaluation to determine the need for a hearing aid and select an appropriate device.
Modifiers may apply depending on the circumstances of the service. Consult the appropriate modifier guidelines.
Medicare requires documentation supporting the medical necessity of the hearing aid assessment. This includes demonstrating the patient's hearing loss significantly impacts their daily communication, social interactions or overall well-being.
Audiologist
In simple words: This code covers a hearing test to figure out if you need a hearing aid and, if so, which one is best for you.A hearing specialist will test your hearing and recommend a hearing aid based on the results.
This HCPCS code, V5010, represents an audiological evaluation performed specifically to assess a patient's need for a hearing aid and to select the most appropriate type of amplification.The evaluation includes a comprehensive hearing assessment to measure the degree and type of hearing loss, followed by a recommendation for a suitable hearing aid based on the assessment findings. This process differs from a general hearing evaluation (e.g., CPT code 92557) which may be performed for other diagnostic purposes.
Example 1: A 65-year-old patient complains of difficulty hearing conversations in noisy environments.An audiologist performs a comprehensive hearing evaluation (V5010) to determine the severity and type of hearing loss, and recommends a specific type of hearing aid based on the results., A 70-year-old patient with known sensorineural hearing loss seeks a hearing aid fitting. The audiologist performs an assessment (V5010) to verify the existing hearing loss and determine the appropriate style and technology of a hearing aid. , A 40-year-old patient with sudden onset hearing loss undergoes a hearing assessment (V5010) as part of a broader diagnostic workup.The assessment focuses on determining hearing aid suitability given the nature and severity of the hearing loss.
** Coverage for this code may vary significantly between payers, including Medicare and Medicaid. Always check individual payer policies for specific coverage criteria and documentation requirements.
- Payment Status: Active (Coverage varies by payer. Medicare coverage requires medical necessity documentation.)
- Modifier TC rule: Not applicable.
- Specialties:Audiology, Otolaryngology
- Place of Service:Office, Clinic, Hospital Outpatient Department