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2025 HCPCS code V5241

Dispensing fee for a monaural hearing aid of any type.

Use the most specific HCPCS code available for the type of hearing aid dispensed. Do not bill separately for individual services included in the dispensing fee.

Medical necessity must be established for the hearing aid, typically through a hearing evaluation and documentation of hearing loss.

Hearing aid dispensers.

In simple words: The cost of getting a single hearing aid, including setup, adjustments, and instructions on how to use and care for it.

This code covers the dispensing fee for any type of monaural hearing aid, including fitting, adjustments, instructions for use, repair/replacement of defective parts, labor, and cleaning.

Example 1: A patient receives their first monaural hearing aid and the dispenser bills for the fitting, adjustments, and instructions., A patient's monaural hearing aid requires repair due to a defective part, and the dispenser uses this code for the service., A patient needs a replacement monaural hearing aid due to loss or damage, and the dispenser bills for the dispensing fee, including fitting and adjustments.

Documentation should include the type of hearing aid dispensed, date of service, and any repairs or adjustments performed.

** Coverage for this code may vary among payers. Check with individual payers for their specific coverage policies.

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

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