The National Health Interview Survey found that approximately 10 percent of U.S. adults had experienced tinnitus in the 12 months previous to the survey (Bhatt et al, 2016; Shargorodsky et al, 2010). This article reviews codes useful when providing tinnitus services. For clinical guidance, the interested reader is directed to the American Academy of Otolaryngology Head and Neck Surgery Clinical Practice Guideline for Tinnitus (Tunkel et al, 2014). Although tinnitus services and devices are billed to a variety of payers, this article focuses on guidance for filing claims for Medicare beneficiaries and appropriate coding based on procedures chosen at the discretion of the clinician.

Evaluation and Associated Current Procedural Terminology (CPT) Codes

The following diagnostic procedures are commonly used by audiologists in audiologic assessments for patients with tinnitus.




Comprehensive audiometry, threshold evaluation and speech recognition (92553 and 92556 combined)


Tympanometry (Impedance testing)


Tympanometry and acoustic reflex threshold measurements


Acoustic immittance testing, includes tympanometry (impedance testing), acoustic reflex threshold testing and acoustic reflex decay testing.


Distortion product otoacoustic emissions; limited evaluation (to confirm the presence or absence of hearing disorder, 3-6 frequencies) or transient evoked otoacoustic emissions, with interpretation and report


Distortion product-evoked otoacoustic emissions; comprehensive diagnostic evaluation (quantitative analysis of outer hair cell function by cochlear mapping, minimum of 12 frequencies), with interpretation and report


All codes presented in this section assume binaural procedures; if only one ear is tested, usage of the -52 Reduced Services modifier is recommended. As a reminder, under the description for 92557—Comprehensive audiometry, threshold evaluation, and speech recognition—all four components (air- and bone-conduction pure-tone testing, speech-recognition threshold, and suprathreshold word discrimination) should be completed. 

For more specific coding information for acoustic reflex threshold measurement (included in 92550: Tympanometry and acoustic reflex threshold measurements and 92570: Acoustic immittance testing) and appropriate use of 92587: Distortion product otoacoustic emissions, limited evaluation and 92588: Distortion product otoacoustic emissions, comprehensive diagnostic evaluation, the reader is directed to the Coding and Reimbursement section of the Academy’s website, (American Academy of Audiology, 2019).

Tinnitus Evaluation

Measurements of tinnitus can be useful to document its presence, to demonstrate the need for counseling, and to guide and monitor progress with treatment options such as sound therapy. Tinnitus assessment is encompassed by one code, 92625: Assessment of tinnitus. As with other audiology procedure codes, 92625 is a bilateral code and usage of the -52 Reduced Services modifier is recommended for unilateral testing.




Assessment of tinnitus (includes pitch, loudness matching, and masking)


Voluntary or mandatory quality reporting through the Merit-Based Incentive Payment System (MIPS) program may also require the use of additional components in tinnitus assessment. Some patients can have strong emotional reactions to their tinnitus (Tyler and Baker, 1983), including depression (Langguth et al, 2011). There is a quality measure associated with a billed 92625: Assessment of tinnitus, MIPS Measure #134. Detailed information on MIPS reporting for 2020 can be found in the January/February 2020 issue of Audiology Today (Kovar, 2020).


Definition: For practitioners participating in the MIPS program, patients undergoing 92625: Assessment of tinnitus should complete a standardized depression screening tool. If applicable, a follow-up plan should be established and may include referral to a practitioner who is qualified to diagnose the condition and/or additional evaluation.



Positive screen for clinical depression using an age-appropriate standardized tool and a follow-up plan documented



Negative screen for clinical depression using an age-appropriate standardized tool, follow-up not required



Documentation stating patient has active diagnosis of depression or has diagnosed bipolar disorder by a physician or mental health professional, screening not required



Screening for clinical depression using an age-appropriate standardized tool not documented, patient not eligible/ refuses to participate


No documentation of clinical depression screening using an age appropriate standardized tool


Positive screen for clinical depression using an age-appropriate standardized tool documented, follow-up plan not documented, reason not specified

+ MIPS performance standards met
* Denominator exception (partial points awarded toward quality score)
Performance standard not met

For more information on scoring and reporting of MIPS measures, readers are encouraged to review resources from the Centers for Medicare and Medicaid Services (CMS) website (CMS, 2020).

Tinnitus Diagnosis 

The current ICD-10 code set provides two classifications: tinnitus and pulsatile tinnitus. Subjective tinnitus can be perceived only by the patient. Objective tinnitus can be perceived by the patient and the examiner.



H93.11 Tinnitus
(right ear)

H93.12 Tinnitus
(left ear)

H93.13 Tinnitus

H93.19 Tinnitus
(unspecified ear)

A perceived sound in the absence of an external sound that can be described as a ringing, clicking, whooshing, crickets, radio static, etc., and can be subjective or objective in nature

H93.A1 Pulsatile tinnitus
(right ear)

H93.A2 Pulsatile tinnitus
(left ear)

H93.A3 Pulsatile tinnitus

H93.A9 Pulsatile tinnitus
(unspecified ear)

A perceived sound that coincides with the heartbeat

Tinnitus Management

Hearing Aid Evaluation, Dispensing, and Fitting

An exhaustive review of codes used in hearing aid evaluation, dispensing, and fitting is outside of the scope of this resource. The interested reader is directed to the Academy’s Guide to Itemizing Your Professional Services (American Academy of Audiology, 2014).

Non-Covered Services and Devices

Medicare does not cover audiological treatment options for tinnitus such as hearing aids, sound therapy devices, tinnitus maskers, tinnitus treatment, or counseling. These items and services should not be billed to Medicare for reimbursement. 

In the event that a claim needs to be submitted for denial or the patient requests that the claim be submitted to Medicare, the -GY modifier (Item or service statutorily excluded, does not meet the definition of any Medicare benefit) must be used with any codes used for tinnitus treatment. For more information on the use of modifiers when billing Medicare, the reader is directed to the September/October 2019 issue of Audiology Today (Frank and Jilla, 2019).


In comparison to the 30 million Americans with hearing loss, 50 million Americans report tinnitus. The addition of tinnitus evaluation, diagnosis, and management provides an opportunity to help more patients by mitigating the effects of this disorder. Additional articles on adding tinnitus to your practice are provided by Tyler et al (2008) and Turiff (2017).


American Academy of Audiology. (2014) A guide to itemizing your professional services. Retrieved from

American Academy of Audiology. (2019) Billing and Coding for Audiology Services. Retrieved from

Bhatt JM, Lin HW, Bhattacharyya N. (2016) Prevalence, severity, exposures, and treatment patterns of tinnitus in the United States. JAMA Otolaryngol Head Neck Surg 142(10):959–965.

Centers for Medicare and Medicaid Services. (2020). 2020 Quality Requirements. Retrieved from

Frank J, Jilla AM. (2019) When and why to modify. Audiol Today 31(5):67–69. Retrieved from

Kovar C. (2020) Medicare QPP rules for 2020. Audiol Today 32(1):57–59.

Langguth B, Landgrebe M, Kleinjung T, Sand GP, Hajak G. (2011) Tinnitus and depression. World J Biol Psychiatry 12(7):489–500.

Shargorodsky J, Curhan GC, Farwell WR. (2010) Prevalence and characteristics of tinnitus among US adults. Am J Med 123:711–718.

Tunkel DE, Bauer CA, Sun GH, Rosenfeld RM, Chandrasekhar SS, Cunningham ER Jr, Archer SM, Blakley BW, Carter JM, Granieri EC, Henry JA, Hollingsworth D, Khan FA, Mitchell S, Monfared A, Newman CW, Omole FS, Phillips CD, Robinson SK, Taw MB, Tyler RS, Waguespack R, Whamond EJ. (2014) Clinical Practice Guideline: Tinnitus. Otolaryngol Head Neck Surg 151(2S):S1–S40.

Turiff C. (2017) Practice differentiation through tinnitus management: An overview for beginners. Audiol Today 29(3):12–16.

Tyler RS, Baker LJ. (1983) Difficulties experienced by tinnitus sufferers. J Speech Hear Disord 48(2):150–154.

Tyler RS, Haskell G, Gogle S, Gehringer A. (2008) Establishing a tinnitus clinic in your practice. Am J Audiol 17:25–37.

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