Reimbursement Reminder

Tele-Audiology Resource Guide

Kim Cavitt, Au.D.

Procedures Which May Be Able To Be Provided Via Telehealth With Existing Technologies (if Telehealth Provided By An Audiologist Is Allowed By State Licensure)

  • Ensure that all of the requirements of the code are met.
  • If in your scope of practice and allowed by licensure, individuals can be charged privately for non-covered telehealth services.
    • Coverage more likely to exist if the procedure was covered as a face to face interaction.
    • No coverage if provided to Medicare beneficiaries as audiology is not covered for the provision of telehealth.
    • Coverage may exist through state Medicaid programs and private insurances.
    • Please be cautious in accessing an individual’s third-party hearing aid coverage and benefits for the services indicated with an asterisk. You could, potentially, exhaust an individual’s third-party hearing aid coverage and benefits by accessing those benefits for any service. Please consult individual payers for guidance and be transparent with the individual as to the risks of accessing their benefits for evaluation and service, rather than product.
    • Also, if your practice offers a bundled hearing aid delivery or an unbundled delivery with a service plan option, please proceed with caution regarding all of the codes with an asterisk. If your practice does not currently bill individuals or payers for these services in face to face interactions, your practice needs to consider the ethics and optics of charging for these services, in this environment, via telehealth. Individuals may have already paid for this service in their bundled delivery or service plan.
      • 92531: Spontaneous nystagmus test, including gaze.
      • 92507: Treatment of auditory processing disorder; individual.
      • *92590: Hearing aid examination and selection; monaural.
      • *92591: Hearing aid examination and selection; binaural.
      • *92592: Hearing aid check; monaural.
      • *92593: Hearing aid check; binaural.
      • 92630: Auditory rehabilitation; prelingual hearing loss.
  • 92633: Auditory rehabilitation; postlingual hearing loss.
  • 92700: Unlisted otorhinolaryngological procedure.
    • Used to classify procedures that do not have CPT codes.
    • Common procedures to consider:
      • Communication Needs Assessment.
      • Tinnitus management.
      • Auditory prosthetic device orientation, counseling, troubleshooting and service.
  • 96127: Brief emotional/behaviorial assessment, with scoring and documentation, per standardized instrument.
    • As allowed by state licensure laws.
  • 97129 : Therapeutic interventions that focus on cognitive function (eg, attention, memory, reasoning, executive function, problem solving and/or pragmatic functioning) and compensatory strategies to manage the performance of an activity (eg, managing time or schedules, initiating, organizing and sequencing tasks), direct (one-to-one) individual contact; initial 15 minutes).
    • As allowed by state licensure laws.
  • 97130: Therapeutic interventions that focus on cognitive function (eg, attention, memory, reasoning, executive function, problem solving and/or pragmatic functioning) and compensatory strategies to manage the performance of an activity (eg, managing time or schedules, initiating, organizing and sequencing tasks), direct (one-to-one) individual contact; each additional 15 minutes (list separately in addition to code for primary procedure).
    • As allowed by state licensure laws.
  • S9445: Individual education, not otherwise classified, non-physician provider, individual, per session.
  • S9446: Individual education, not otherwise classified, non-physician provider, group, per session.
  • S9981: Medical records copying fee, administrative.
    • Can be billed with units.
    • State medical records policies dictate what can be charged.
  • S9982: Medical records copying fee, per page.
    • Can be billed with units.
    • State medical records policies dictate what can be charged.
  • V5008: Hearing screening.
    • Same as 92551.
  • *V5010: Assessment for hearing aid.
    • Same as 92590/1.
  • *V5268: Assistive listening device, telephone amplifier, any type.
  • *V5269: Assistive listening device, alerting, any type.
  • *V5270: Assistive listening device, television amplifier, any type.
  • *V5271: Assistive listening device, television caption decoder.
  • *V5272: Assistive listening device, TDD.
  • *V5273: Assistive listening device, for use with cochlear implant.
  • *V5274: Assistive listening device, not otherwise specified.
  • *V5281: Assistive listening device, personal FM/DM system, monaural (1 receiver, transmitter, microphone), any type.
  • *V5282: Assistive listening device, personal FM/DM system, binaural (2 receivers, transmitter, microphone), any type.
  • *V5283: Assistive listening device, personal FM/DM neck, loop induction receiver.
  • *V5284: Assistive listening device, personal FM/DM ear level receiver.
  • *V5285: Assistive listening device, personal FM/DM, direct audio input receiver.
  • *V5286: Assistive listening device, personal Bluetooth FM/DM receiver (streamer.)
  • *V5287: Assistive listening device, personal FM/DM receiver, not otherwise specified.
  • *V5288: Assistive listening device, personal FM/DM transmitter assistive listening device.
  • *V5289: Assistive listening device, personal FM/DM adaptor/boot coupling device for receiver, any type.
  • *V5290: Assistive listening device, transmitter microphone, any type.
  • *V5265: Ear mold/insert/disposable, any type.
    • Per mold (billed with units).
      • Dome.
      • Insert.
  • *V5266: Battery for use in hearing device.
    • Should be billed as multiple units unless advised against it by the payer (Medicaid).
  • *V5267: Hearing aid or assistive listening device/supplies/accessories, not otherwise specified.
    • Billed as separate line items.
  • *V5299: Hearing service, miscellaneous.
    • Extended warranty.
    • Accessory or FM support and service.

Procedures Which May Be Able To Be Provided Via Telehealth With Special Equipment Or Technology (if Telehealth Provided By An Audiologist Is Allowed By State Licensure)

  • Ensure that all of the requirements of the code are met.
  • If in your scope of practice and allowed by licensure, individuals can be charged privately for non-covered telehealth services.
  • Coverage more likely to exist if the procedure was covered as a face to face interaction.
    • No coverage if provided to Medicare beneficiaries as audiology is not covered for the provision of telehealth.
    • Coverage may exist through state Medicaid programs and private insurances.
    • Evaluation and Management Codes, new patient:
      • 99201
      • 99202
      • 99203
    • Evaluation and Management, existing patient:
      • 99211
      • 99212
      • 99213
    • Evaluation and Management, consultation codes:
      • 99241
      • 99242
      • 99243
    • Telephone Assessment and Management Service:
      • 98966
      • 98967
      • 98968
    • Online Digital Evaluation and Management Service:
      • 98970
      • 98971
      • 98972

Remote Assessment

  • Ensure that all of the requirements of the code, and its associated procedure, are met.
  • For hearing aid dispensing, confirm if any test requirements exist for your state.
    • iHear (FDA approved): http://www.ihearmedical.com/ihear-test/ and http://www.prweb.com/releases/2016/01/prweb13147729.htm
    • National Hearing Test: https://www.nationalhearingtest.org/wordpress/
    • Audicus: https://www.audicus.com
    • Jacoti: https://www.jacoti.com/hearingcenter/
    • Music Acoustics: http://newt.phys.unsw.edu.au/jw/hearing.html
    • Nuheara: https://www.nuheara.com/online-hearing-assessment/
    • Lively: http://www.listenlively.com
    • Starkey: http://www.starkey.com/online-hearing-test
    • Widex: https://www.widex.com/en-us/hearing-loss/online-hearing-test
    • Resound: https://www.resound.com/en-us/online-hearing-test
    • Miracle Ear: https://www.miracle-ear.com/hearing-test
    • Spinach Effect: http://www.hearingkiosks.com/
    • Ultimate Kiosk: http://www.ultimatekiosk.com/site/home
    • ShoeBox: https://www.shoebox.md/
    • Kuduwave: https://kuduwave.com/
    • Otohub: https://www.otohub.com/
    • Ototronix: http://www.ototronixdiagnostics.com/otogram.html
    • Auditdata: https://www.auditdata.com/
    • Quadio: http://www.quadio.in/hearing-solutions/quadiometer

Applications (emergency Amplification)

  • Available on mobile phones.
  • No FDA regulations.
    • EarMachine: http://www.earmachine.com/
    • EarSpy: http://www.earspyapp.com/
    • Fennex: https://www.fennex.io/ (turns AirPods into amplifier)
    • HearingOS: http://www.hearingos.com/
    • Jacoti: https://www.jacoti.com/
    • Mimi: https://mimi.io/en/behind-mimi/
    • Petralex: http://petralex.pro/
    • Volume Boost
    • Hear Boost
    • Search “hearing aid” in app store and you will see many additional options.

Questions? Please contact Kim Cavitt at This email address is being protected from spambots. You need JavaScript enabled to view it. or 773-960-6625 (text or call).