Tables 1-6 see below for APC assignments, status indicators, and reimbursement amounts for audiology codes. An “S” status indicator denotes a “Separate APC Payment” where regardless of services performed on the same date of service, the CPT code is paid at the APC rate. A “Q1” status indicator represents “STV-Packaged Codes” where APCs and CPT codes billed on the same date of service as those assigned a status indicator of “S”, “T” or “V” are packaged and not paid for separately. If billed without the “S,” “T,” or “V” service, payment is made at the APC rate. Status indicator “N” indicates payment is packaged into payment for other services, therefore no separate APC payment will be allowed.

Table 1: APC 5721-Level I Diagnostic Tests and Related Services (2018 final = $136.31)

  • (2019 final = $135.95)
  • (2020 proposed = $140.33)
  • (2020 final = $138.33)
CPT CodeCode DescriptorStatus Indicator 2018 FinalStatus Indicator 2019 FinalStatus Indicator 2020 Final
92537Caloric vestibular test with recording, bilateral; bithermal* moved here from APC 5722SSS
92538Caloric vestibular test with recording, bilateral; monothermal* moved here from APC 5722SSS
92540Basic vestibular evaluationSSS
92544Optokinetic nystagmus test, bidirectional, foveal or peripheral stim, w/recordingSSS
92545Oscillating tracking test, with recordingSSS
92546Sinusoidal vertical axis rotational testingSSS
92584ElectrocochleographySSS
92586Auditory evoked potentials, limitedSSS
92601Cochlear Implant initial programming <7 years oldSSS
92602Subsequent programming <7 years oldSSS
92603Cochlear implant initial programming >7 years oldSSS
92604Subsequent programming >7 years oldSSS
92640Auditory brainstem implant programmingSSS
92550Tympanometry & reflex thresholdQ1Q1Q1
92553Audiometry air and boneQ1Q1Q1
92557Comprehensive hearing evaluationQ1Q1Q1
92562Loudness balance testQ1Q1Q1
92570Acoustic immittance testingQ1Q1Q1
92572Staggered spondaic word testQ1Q1Q1
92579Visual audiometry (VRA)Q1Q1Q1
92582Conditioning play audiometryQ1Q1Q1
92620Auditory function test (60 min)Q1Q1Q1
92625Tinnitus assessmentQ1Q1Q1
92626Evaluation of auditory rehab statusQ1Q1Q1

Table 2: APC 5722-Level II Diagnostic Tests and Related Services (2018 final = $248.81)

  • (2019 final = $252.31)
  • (2020 proposed = $256.60)
  • (2020 final = $253.07)
CPT CodeCode DescriptorStatus Indicator 2018 FinalStatus Indicator 2019 FinalStatus Indicator 2020 Final
92585Auditory evoked potentials (ABR), comprehensiveSSS
92587OAEs, limitedSSS
92588OAEs, comprehensiveSSS

Table 3: APC 5723-Level III Diagnostic Tests and Related Services (2018 final = $444.36)

  • (2019 final = $455.27)
  • (2020 proposed = $486.65)
  • (2020 final = $485.55)
CPT CodeCode DescriptorStatus Indicator 2018 FinalStatus Indicator 2019 FinalStatus Indicator 2020 Final
92577Stenger test, speechQ1Q1Q1

Table 4: APC 573-Level I Minor Procedures (2018 final =$17.47)

  • (2019 final = $17.17)
  • (2020 proposed = $23.57)
  • (2020 final = $ 22.98)
CPT CodeCode DescriptorStatus Indicator 2018 FinalStatus Indicator 2019 FinalStatus Indicator 2020 Final
92564SISI hearing test* moved here from APC 5732Q1Q1Q1
92700Unlisted otorhinolaryngological service or procedureQ1Q1Q1

Table 5: APC 5732-Level II Minor Procedures (2018 final = $31.80)

  • (2019 final = $32.12)
  • (2020 proposed = $34.33)
  • (2020 final = $33.43)
CPT CodeCode DescriptorStatus Indicator 2018 FinalStatus Indicator 2019 FinalStatus Indicator 2020 Final
92555Speech threshold audiometryQ1Q1Q1
92556Speech threshold and discriminationQ1Q1Q1
92563Tone decay hearing testQ1Q1Q1
92565Stenger test, pure toneQ1Q1Q1
92567TympanometryQ1Q1Q1
92568Acoustic reflex thresholdQ1Q1Q1
92571Filtered speech testQ1Q1Q1
92575Sensorineural acuity testQ1Q1Q1
92576Synthetic sentence testQ1Q1Q1
92583Select picture audiometryQ1Q1Q1
92596Ear protection measurementQ1Q1Q1

Table 6: APC 5734-Level IV Minor Procedures (2018 final = $105.03)

  • (2019 final = $106.48)
  • (2020 proposed = $109.98)
  • (2020 final = $109.02)
CPT CodeCode DescriptorStatus Indicator 2018 FinalStatus Indicator 2019 FinalStatus Indicator 2020 Final
92541Spontaneous nystagmus testQ1Q1Q1
92542Positional nystagmus testQ1Q1Q1
92548PosturographyQ1Q1Q1
92552Pure tone audiometry airQ1Q1Q1
92561Bekesy audiometry diagnosisQ1Q1Q1
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