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2025 HCPCS code V5090

Dispensing fee for an unspecified hearing aid.

Use modifiers LT and RT to indicate left and right ear respectively, when billing for monaural hearing aids.Do not use V5090 if a more specific code for the hearing aid is available.

Modifiers LT and RT can be used to indicate left and right ear respectively.

Medical necessity for a hearing aid must be established. This usually involves a hearing evaluation demonstrating hearing loss that significantly impacts the patient's daily life.

The clinician is responsible for selecting, fitting, and providing instruction on the use of the hearing aid.

IMPORTANT:For monaural dispensing fees, consider V5241.If a more specific code is available for the type of hearing aid dispensed, use that code instead of V5090.

In simple words: The fee charged by a healthcare provider for fitting and giving instructions on how to use a hearing aid, when the type of hearing aid isn't specified.

This code covers the dispensing fee for a hearing aid when the specific type of hearing aid is not specified. It includes services related to the selection, fitting, and patient instruction.

Example 1: A patient receives a bone conduction hearing aid. The provider uses V5090 because the specific type of bone conduction hearing aid is not documented., A patient is fitted with an FM system or vibrotactile device. V5090 is used as no specific code exists for these., A patient with bilateral hearing loss receives two hearing aids. If billed separately and type of hearing aid is not specified, V5090 can be used for each along with modifiers RT and LT.

Documentation should support the medical necessity of the hearing aid. If a specific type of hearing aid was dispensed, that information needs to be documented as well.

** Coverage for this code may vary among payers. Check with individual payers to determine coverage policies. Some payers may require prior authorization for hearing aids and related services.

** Only Enterprise users with EHR integration can access case-specific answers. Click here to request access.

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