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 codes are available for reporting vestibular and related balance assessments.
| CPT Code | Description |
| 92537 | Caloric vestibular test with recording, bilateral; bithermal (ie, one warm and one cool irrigation in each ear for a total of four irrigations)
Do not report 92537 in conjunction with 92270, 92538 For three irrigations, use modifier 52 For monothermal caloric vestibular testing, use 92538 |
| 92538 | Caloric vestibular test with recording, bilateral; monothermal (ie, one irrigation in each ear for a total of two irrigations)
Do not report 92538 in conjunction with 92270, 92537 For one irrigation, use modifier 52 For bilateral, bithermal caloric vestibular testing, use 92537 |
Medicare Coverage Policies for Vestibular Assessment and Treatment
Medicare provides coverage for vestibular assessment and evaluation when medically necessary but does not cover treatment or management options for vestibular or balance-related issues when performed by audiologists. Most commonly, treatment or management options would include canalith repositioning procedures and vestibular rehabilitation therapy. These non-covered services should not be billed to Medicare when performed by audiologists. If claims need to 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 with any codes for these non-covered services and/or devices. Additional information on Medicare coverage policies for audiologic procedures can be found here.
Frequently Asked Questions
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.
