Skip to content
American Academy of Audiology
  • PRACTICE RESOURCES
    • Practice Guidelines and Standards
    • Coding
    • Medicare/Medicaid
    • Compliance
  • EDUCATION & EVENTS
    • Event Calendar
    • Continuing Education
    • Online Learning and Certificate Programs
    • Research Grants and Scholarships
    • Faculty and Preceptor Resources
  • AAA ANNUAL CONFERENCE
    • Attend
    • Program and Events
    • Exhibit Hall
    • Exhibit and Sponsorship Opportunities
    • About
  • NEWS & PUBLICATIONS
    • News
    • Audiology Today
    • Journal of the American Academy of Audiology
    • Advertising
    • Permissions and Reprints
    • Press and Media Information
  • CAREERS
    • Career Center
    • Certification
    • Become an Audiologist
    • Doctoral Programs in Audiology
    • Recruiting
    • New Professional Toolkit
  • ADVOCACY
    • Legislative and Regulatory Activities
      • State Affairs
      • Federal Affairs
    • Legislative Action Center
    • Government Relations News
  • CONSUMERS
    • What Is an Audiologist
    • Hearing and Balance Symptoms and Conditions
    • Managing Hearing Loss
    • Seniors and Hearing Loss
    • Children and Hearing Loss
    • OTC Hearing Aid
  • ABOUT THE ACADEMY
    • Leadership
    • Committees and Task Forces
    • Get Involved
    • Honors and Awards
    • Sponsorships and Corporate Partners
    • Contact Us
  • MEMBERSHIP
    • Benefits
    • Ethics
    • Member Directory
    • Membership Renewals
FacebookTwitterLinkedinYoutubeInstagram
  • Students
  • Get Involved
  • Donate
  • Renew
American Academy of Audiology
Member Login
  • PRACTICE RESOURCES
    • Practice Guidelines and Standards
    • Coding
    • Medicare/Medicaid
    • Compliance
  • EDUCATION & EVENTS
    • Event Calendar
    • Continuing Education
    • Online Learning and Certificate Programs
    • Research Grants and Scholarships
    • Faculty and Preceptor Resources
  • AAA ANNUAL CONFERENCE
    • Attend
    • Program and Events
    • Exhibit Hall
    • Exhibit and Sponsorship Opportunities
    • About
  • NEWS & PUBLICATIONS
    • News
    • Audiology Today
    • Journal of the American Academy of Audiology
    • Advertising
    • Permissions and Reprints
    • Press and Media Information
  • CAREERS
    • Career Center
    • Certification
    • Become an Audiologist
    • Doctoral Programs in Audiology
    • Recruiting
    • New Professional Toolkit
  • ADVOCACY
    • Legislative and Regulatory Activities
      • State Affairs
      • Federal Affairs
    • Legislative Action Center
    • Government Relations News
  • CONSUMERS
    • What Is an Audiologist
    • Hearing and Balance Symptoms and Conditions
    • Managing Hearing Loss
    • Seniors and Hearing Loss
    • Children and Hearing Loss
    • OTC Hearing Aid
  • ABOUT THE ACADEMY
    • Leadership
    • Committees and Task Forces
    • Get Involved
    • Honors and Awards
    • Sponsorships and Corporate Partners
    • Contact Us
  • MEMBERSHIP
    • Benefits
    • Ethics
    • Member Directory
    • Membership Renewals
wave-mark-white
December 12, 2020

CMS Issues Final 2021 Hospital Outpatient Prospective Payment System Rule

  • Coding and Reimbursement

Tables 1-6 see below for APC assignments, status indicators, and reimbursement amounts for audiology codes.  An โ€œSโ€ status indicator denotes a โ€œSeparate APC Paymentโ€ where regardless of services performed on the same date of service, the CPT code is paid at the APC rate. A โ€œQ1โ€ status indicator represents โ€œSTV-Packaged Codesโ€ where APCs and CPT codes billed on the same date of service as those assigned a status indicator of โ€œSโ€, โ€œTโ€ or โ€œVโ€ are packaged and not paid for separately. If billed without the โ€œS,โ€ โ€œT,โ€ or โ€œVโ€ service, payment is made at the APC rate. Status indicator โ€œNโ€ indicates payment is packaged into payment for other services, therefore no separate APC payment will be allowed. Status indicator โ€œE1โ€ is not paid by Medicare when submitted on outpatient claims. New CPT 92650 for 2021 (Aep scr auditory potential) has a status indicator of E1 and is not assigned to an APC.

Table 1:  APC 5721-Level I Diagnostic Tests and Related Services

(2018 final = $136.31)

(2019 final = $135.95)

(2020 final = $138.33)

(2021 final = $139.55)    

CPT CodeCode DescriptorStatus Indicator (SI) 2018 Final2019 Final2020 Final2021 Final
92537*Caloric vestibular test with recording, bilateral; bitherma (moved here from APC 5722)SSSS
92538*Caloric vestibular test with recording, bilateral; monothermal (moved here from APC 5722)SSSS
92540Basic vestibular evaluationSSSS
92544Optokinetic nystagmus test, bidirectional, foveal or peripheral stim, w/recordingpSSSS
92546Sinusoidal vertical axis rotational testingSSSS
92584ElectrocochleographySSSS
92586Auditory evoked potentials, limited (discontinued)SSS 
92601Cochlear Implant initial programming <7 years oldSSSS
92602Subsequent programming <7 years oldSSSS
92603Cochlear implant initial programming > 7 years oldSSSS
92604Subsequent programming >7 years oldSSSS
92640Auditory brainstem implant programmingSSSS
92550Tympanometry & reflex thresholdQ1Q1Q1Q1
92553Audiometry air and boneQ1Q1Q1Q1
92557Comprehensive hearing evaluationQ1Q1Q1Q1
92562Loudness balance testQ1Q1Q1Q1
92570Acoustic immitance testingQ1Q1Q1Q1
92572Staggered spondaic word testQ1Q1Q1Q1
92579Visual audiometry (VRA)Q1Q1Q1Q1
92582Conditioning play audiometryQ1Q1Q1Q1
92620Auditory function test (60 min)Q1Q1Q1Q1
92625Tinnitus assessmentQ1Q1Q1Q1
92626Evaluation of auditory rehab statusQ1Q1Q1Q1
92651Aep hearing status deter i&r NEW for 2021   S
92517Vemp test i&r cervical โ€“ NEW 2021   S
92518Vemp test i&r ocular- NEW 2021   S

Table 2:  APC 5722- Level II Diagnostic Tests and Related Services

(2018 final = $248.81)

(2019 final = $252.31)

(2020 final = $253.07)

(2021 final = $264.45) 

CPT CodeCode DescriptorSI 2018 Final2019 Final2020 Final2021 Final
92545*Oscillating tracking test with recording (moved here from APC 5721)SSSS
92585Auditory evoked potentials (ABR), comprehensive (discontinued)SSS 
92587OAEs, limitedSSSS
92588OAEs, comprehensiveSSSS
92519Vemp tst i&r cervical&ocular NEW 2021   S
92652Aep thrshld est mlt freq i&r NEW 2021   S
92653Aep neurodiagnostic i&r NEW 2021   S

Table 3: APC 5723- Level III Diagnostic Tests and Related Services

(2018 final = $444.36)

(2019 final = $455.27)

(2020 final = $485.55)

(2021 final = $487.78)            

                                                                                                                          CPT CodeCode DescriptorSI 2018 Final2019 Final2020 Final2021 Final
92577Stenger test, speechQ1Q1Q1Q1

Table 4: APC 5731- Level I Minor Procedures

(2018 final = $17.47)

(2019 final = $17.17)

(2020 final = $22.98)

(2021 final = $24.67)

CPT CodeCode DescriptorSI 2018 Final2019 Final2020 Final2021 Final
92564SISI hearing testQ1Q1Q1Q1
92700Unlisted otorhinolaryngological service or procedureQ1Q1Q1Q1

Table 5: APC 5732- Level II Minor Procedures

(2018 final = $31.80)

(2019 final = $32.12)

(2020 final = $33.43)  

(2021 final = $33.84)

CPT CodeCode DescriptorSI 2018 Final2019 Final2020 Final2021 Final
92555Speech threshold audiometryQ1Q1Q1Q1
92563Tone decay hearing testQ1Q1Q1Q1
92565Stenger test, pure toneQ1Q1Q1Q1
92567TympanometryQ1Q1Q1Q1
92568Acoustic reflex thresholdQ1Q1Q1Q1
92571Filtered speech testQ1Q1Q1Q1
92575Sensorineural acuity testQ1Q1Q1Q1
92576Synthetic sentence testQ1Q1Q1Q1
92596Ear protection measurementQ1Q1Q1Q1

Table 6:  APC 5733 โ€“ Level III Minor Procedures *NEW assignment for two audiology codes in 2021

(2021 final = $55.66)

CPT CodeCode Descriptor2021 Final
92556*Speech threshold and discrimination (moved here from APC 5732)Q1
92583*Select picture audiometry (moved here from APC 5732)Q1

Table 7: APC 5734- Level IV Minor Procedures

(2018 final =$105.03)

(2019 final = $106.48)

(2020 final = $109.02)

(2021 final = $111.95)

CPT CodeCode DescriptorSI 2018 Final2019 Final2020 Final2021 Final
92541Spontaneous nystagmus testQ1Q1Q1Q1
92542Positional nystagmus testQ1Q1Q1Q1
92548PosturographyQ1Q1Q1Q1
92552Pure tone audiometry airQ1Q1Q1Q1
92561Bekesy audiometry diagnosisQ1Q1Q1Q1
Share this

Related Posts

New Codes for Rotational Vestibular Assessment

NASEM Releases Report on Meaningful Outcomes in Adult Hearing Health Care

Clarifications on Telehealth Services under the Medicare Physician Fee Schedule for CY 2025

Recent Posts

Audiology in the News

Admission Rates of Neonatal Intensive Care Units in the United States

Pediatric audiology case-history questionnaires often ask about birth history and time spent in a neonatal intensive care unit (NICU). As such, audiologists who routinely see…

Read More
Audiology in the News

A New Flexible Auditory Brainstem Implant

An auditory brainstem implant (ABI) provides the sensation of sound to individuals who are deaf due to neurofibromatosis 2 (NF2) or a severely compromised or…

Read More
Government Relations News

Nevada Passes Bill to Join ASLP-IC as Legislative Session Closes

On the final day of the Nevada Legislative Session, lawmakers passed Assembly Bill (AB) 230, which was then sent to Governor Joe Lombardo for signature….

Read More
wave-mark

Join the Academy

Academy members receive many benefits for professional development, practice management, and community development.

Become a Member
COMM24-Academy_Website_Graphics-revised_logo(W)

American Academy of Audiology
11480 Commerce Park Drive
Suite 220
Reston, VA 20191

Tel: 703-790-8466
Fax: 703-790-8631

  • Practice Resources
  • Education and Events
  • AAA Annual Conference
  • News and Publications
  • Careers
  • Advocacy
  • About the Academy
  • Consumers and Patients
  • Students
  • Donate
  • Get Involved
  • Contact Us
  • Privacy Policy
  • Antitrust Policy and Guidelines
  • Terms of Use Policy
  • Accessibility Statement
  • Sitemap

© Copyright 2025 American Academy of Audiology

Website by Yoko Co

This content is an exclusive benefit for American Academy of Audiology members.

If you’re a member, log in and you’ll get immediate access.

 

Member Login

 

If you’re not yet a member, you’ll be interested to know that joining not only gives you access to top-notch resources like this one, but also invitations to member-only events, inclusion in the member directory, participation in professional forums, and access to patient resources, tools, and continuing education. Join today!

Scroll To Top
We use cookies to improve your experience on our site. By continuing to use our site, you accept our use of cookies. To learn more, please see our Privacy Policy.Ok