Clinicians are encouraged to reference their CPT manual for correct code use and to review payer-specific policies when determining appropriate code reporting and documentation requirements for services. Many payer clinical policies will provide criteria for Medical Necessity and will also include procedure and diagnosis codes that will support medical necessity and policies for subsequent reimbursement for services. It is advisable to review payer guidelines and policies prior to billing.
Relevant Procedure Codes
The following CPT code is available for reporting diagnostic assessment of tinnitus. There are currently no CPT codes that encompass assessment and management for hyperacusis and misophonia. You may consider 92700 (unlisted otorhinolaryngologic service or procedure) if billing insurance for hyperacusis or misophonia assessment and management. For more information regarding the additional documentation needed for reporting 92700, see Coding and Reimbursement: Demystifying CPT Code 92700.
| CPT Code | Description | ||
| 92625 | Assessment of tinnitus (includes, pitch, loudness matching, and masking) | ||
| Note: Other audiometric procedures that may be included as part of a tinnitus assessment (e.g., otoacoustic emissions, pure tone audiometry, tympanometry, etc.) are discussed elsewhere in coding guidance by topic. Learn More | |||
Relevant Diagnosis Codes
The following ICD codes are available for reporting tinnitus, hyperacusis, or other auditory perceptions:
| ICD-10 Diagnosis Codes |
| H93.11 Tinnitus (right ear) H93.12 Tinnitus (left ear) H93.13 Tinnitus (bilateral) H93.19 Tinnitus (unspecified ear) |
| H93.A1 Pulsatile tinnitus (right ear) H93.A2 Pulsatile tinnitus (left ear) H93.A3 Pulsatile tinnitus (bilateral) H93.A9 Pulsatile tinnitus (unspecified ear) |
| H93.231 Hyperacusis (right ear) H93.232 Hyperacusis (left ear) H93.233 Hyperacusis (bilateral) H93.239 Hyperacusis (unspecified ear) |
| H93.291 Other abnormal auditory perceptions (right ear) H93.292 Other abnormal auditory perceptions (left ear) H93.293 Other abnormal auditory perceptions (bilateral) H93.299 Other abnormal auditory perceptions (unspecified ear) |
Medicare Coverage Policies for Audiologic Assessment and Treatment of Tinnitus
Medicare provides coverage for tinnitus assessment and evaluation but does not cover audiological treatment or management options for tinnitus. Treatment services for tinnitus, hyperacusis and misophonia should be billed directly to the patient. These may include hearing aids, sound therapy devices, tinnitus maskers, programmatic tinnitus treatments, or tinnitus-related audiologic counseling. These non-covered services should not be billed to Medicare. If claims must be submitted for denial (e.g., for coordination with a secondary insurance plan) or if 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. Additional information on Medicare coverage policies for audiologic procedures can be found here.
Frequently Asked Questions
- How do I report 92625 (Assessment of Tinnitus) if testing was only performed on one ear?
- How do I report tinnitus, hyperacusis, and misophonia assessment and management procedures which do not have a CPT code?
- Are there any codes available to report for tinnitus, misophonia, and/or hyperacusis supplies, items, or related durable medical equipment?
- What is the difference between ICD diagnosis codes for Tinnitus (H93.11-H93.19) and Other Abnormal Auditory Perceptions (H93.291-H93.299)?
- When is it appropriate to report Auditory Hallucinations (R44.0)?
Need more help?
Contact us at reimbursement@audiology.org.
*CPT codes, descriptions, and other data are Copyright 1966, 1970, 1973, 1977, 1981, 1983–2025 American Medical Association. All rights reserved. CPT© is a registered trademark of the American Medical Association.
Disclaimer
The purpose of the information provided by the American Academy of Audiology Coding and Reimbursement Committee is strictly for educational guidance to audiologists. Action taken with respect to the information provided is an individual choice. The American Academy of Audiology hereby disclaims any responsibility for the consequences of any action(s) taken by any individual(s) as a result of using the information provided, and reader agrees not to take action against, or seek to hold, or hold liable, the American Academy of Audiology for the reader's use of the information provided. As used herein, the "American Academy of Audiology" shall be defined to include its directors, officers, employees, volunteers, members, and agents.
