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. Status indicator “E1” 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 Code | Code Descriptor | Status Indicator (SI) 2018 Final | 2019 Final | 2020 Final | 2021 Final |
| 92537* | Caloric vestibular test with recording, bilateral; bitherma (moved here from APC 5722) | S | S | S | S |
| 92538* | Caloric vestibular test with recording, bilateral; monothermal (moved here from APC 5722) | S | S | S | S |
| 92540 | Basic vestibular evaluation | S | S | S | S |
| 92544 | Optokinetic nystagmus test, bidirectional, foveal or peripheral stim, w/recordingp | S | S | S | S |
| 92546 | Sinusoidal vertical axis rotational testing | S | S | S | S |
| 92584 | Electrocochleography | S | S | S | S |
| 92586 | Auditory evoked potentials, limited (discontinued) | S | S | S | |
| 92601 | Cochlear Implant initial programming <7 years old | S | S | S | S |
| 92602 | Subsequent programming <7 years old | S | S | S | S |
| 92603 | Cochlear implant initial programming > 7 years old | S | S | S | S |
| 92604 | Subsequent programming >7 years old | S | S | S | S |
| 92640 | Auditory brainstem implant programming | S | S | S | S |
| 92550 | Tympanometry & reflex threshold | Q1 | Q1 | Q1 | Q1 |
| 92553 | Audiometry air and bone | Q1 | Q1 | Q1 | Q1 |
| 92557 | Comprehensive hearing evaluation | Q1 | Q1 | Q1 | Q1 |
| 92562 | Loudness balance test | Q1 | Q1 | Q1 | Q1 |
| 92570 | Acoustic immitance testing | Q1 | Q1 | Q1 | Q1 |
| 92572 | Staggered spondaic word test | Q1 | Q1 | Q1 | Q1 |
| 92579 | Visual audiometry (VRA) | Q1 | Q1 | Q1 | Q1 |
| 92582 | Conditioning play audiometry | Q1 | Q1 | Q1 | Q1 |
| 92620 | Auditory function test (60 min) | Q1 | Q1 | Q1 | Q1 |
| 92625 | Tinnitus assessment | Q1 | Q1 | Q1 | Q1 |
| 92626 | Evaluation of auditory rehab status | Q1 | Q1 | Q1 | Q1 |
| 92651 | Aep hearing status deter i&r NEW for 2021 | S | |||
| 92517 | Vemp test i&r cervical – NEW 2021 | S | |||
| 92518 | Vemp 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 Code | Code Descriptor | SI 2018 Final | 2019 Final | 2020 Final | 2021 Final |
| 92545* | Oscillating tracking test with recording (moved here from APC 5721) | S | S | S | S |
| 92585 | Auditory evoked potentials (ABR), comprehensive (discontinued) | S | S | S | |
| 92587 | OAEs, limited | S | S | S | S |
| 92588 | OAEs, comprehensive | S | S | S | S |
| 92519 | Vemp tst i&r cervical&ocular NEW 2021 | S | |||
| 92652 | Aep thrshld est mlt freq i&r NEW 2021 | S | |||
| 92653 | Aep 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 Code | Code Descriptor | SI 2018 Final | 2019 Final | 2020 Final | 2021 Final |
| 92577 | Stenger test, speech | Q1 | Q1 | Q1 | Q1 |
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 Code | Code Descriptor | SI 2018 Final | 2019 Final | 2020 Final | 2021 Final |
| 92564 | SISI hearing test | Q1 | Q1 | Q1 | Q1 |
| 92700 | Unlisted otorhinolaryngological service or procedure | Q1 | Q1 | Q1 | Q1 |
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 Code | Code Descriptor | SI 2018 Final | 2019 Final | 2020 Final | 2021 Final |
| 92555 | Speech threshold audiometry | Q1 | Q1 | Q1 | Q1 |
| 92563 | Tone decay hearing test | Q1 | Q1 | Q1 | Q1 |
| 92565 | Stenger test, pure tone | Q1 | Q1 | Q1 | Q1 |
| 92567 | Tympanometry | Q1 | Q1 | Q1 | Q1 |
| 92568 | Acoustic reflex threshold | Q1 | Q1 | Q1 | Q1 |
| 92571 | Filtered speech test | Q1 | Q1 | Q1 | Q1 |
| 92575 | Sensorineural acuity test | Q1 | Q1 | Q1 | Q1 |
| 92576 | Synthetic sentence test | Q1 | Q1 | Q1 | Q1 |
| 92596 | Ear protection measurement | Q1 | Q1 | Q1 | Q1 |
Table 6: APC 5733 – Level III Minor Procedures *NEW assignment for two audiology codes in 2021
(2021 final = $55.66)
| CPT Code | Code Descriptor | 2021 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 Code | Code Descriptor | SI 2018 Final | 2019 Final | 2020 Final | 2021 Final |
| 92541 | Spontaneous nystagmus test | Q1 | Q1 | Q1 | Q1 |
| 92542 | Positional nystagmus test | Q1 | Q1 | Q1 | Q1 |
| 92548 | Posturography | Q1 | Q1 | Q1 | Q1 |
| 92552 | Pure tone audiometry air | Q1 | Q1 | Q1 | Q1 |
| 92561 | Bekesy audiometry diagnosis | Q1 | Q1 | Q1 | Q1 |
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