HCPCS Code V5248: Hearing Aid, Analog, Binaural, CIC

Key takeaways

HCPCS code V5248 describes a hearing aid, analog, binaural, completely-in-canal (CIC), a Permanent National Level II code CMS made effective January 1, 2002.

Medicare Part B statutorily excludes routine hearing aids, including V5248, under Social Security Act Section 1862(a)(7), so standard Part B never covers this code.

Medicaid coverage for V5248 varies by state, so confirm your state Medicaid plan’s rules before billing this code.

Practice management software like Pabau helps audiology practices link HCPCS code entries to clinical documentation for accurate, audit-ready records.

HCPCS code V5248 describes a hearing aid, analog, binaural, completely-in-canal (CIC), a Permanent National Level II code CMS maintains within the V52xx hearing aid series. Audiologists, hearing aid dispensers, and otolaryngology practices bill it through Medicaid and applicable private payers.

This guide covers the official code description, 2026 fee schedule data, Medicare and Medicaid coverage rules, and billing documentation requirements. It also shows how V5248 compares with related V52xx codes. The series covers nearly a dozen adjacent hearing aid configurations. Matching the device to its exact code is the most common source of billing errors in this range.

HCPCS code V5248: official description and code details

CMS’s official description for claims management purposes is: Hearing aid, analog, binaural, cic. The lowercase notation is deliberate: CMS publishes V-code descriptions in lowercase in its annual HCPCS release files.

According to CMS, HCPCS Level II codes are alphanumeric codes used to describe products, supplies, and services not covered by CPT. The V-code series within HCPCS Level II covers vision and hearing services, with V5244 through V5261 covering the full range of hearing aid device types.

Understanding the V5248 device: analog, binaural, and CIC explained

Getting the code right starts with understanding exactly what device it describes. Each element of the V5248 description has a specific clinical and billing meaning that determines which code applies to the device being dispensed.

• Analog: The hearing aid uses analog signal processing rather than digital. Analog devices amplify all incoming sound uniformly, without the frequency-specific programming of digital devices. The distinction matters because digital hearing aids occupy a separate HCPCS code series (V5256 onward for binaural digital).
• Binaural: The device covers both ears. One unit of V5248 represents a binaural fitting, meaning one claim covers hearing aids dispensed to both the left and right ear simultaneously. This is distinct from monaural codes (single-ear devices) in the V5244-V5247 range.
• CIC (Completely-In-Canal): The hearing aid fits entirely within the ear canal, making it the least visible style. CIC devices are distinct from ITE (in-the-ear) and BTE (behind-the-ear) styles, each of which carries its own HCPCS code within the V52xx series.

These three descriptors together specify a unique device category. A patient receiving analog binaural behind-the-ear aids, for example, would be billed under a different V-code, not V5248. Misidentifying the style or configuration is the most common coding error in this series.

V5248 vs related hearing aid HCPCS codes

The V52xx hearing aid code series covers dozens of device configurations. The table below maps the analog binaural and monaural CIC codes, along with adjacent styles. Use it to quickly identify the right code when the device differs from V5248. This is the section where most billing confusion occurs, because the codes look similar but describe distinct fittings.

Use the AAPC HCPCS lookup to confirm the current V52xx series before you select a code. The distinction between CIC, ITC, ITE, and BTE styles, and between monaural and binaural configurations, drives the entire code selection decision in this range.

Connecting your practice management platform to your billing workflow reduces these errors upstream. See how EHR integration keeps device records and claims data in sync.

Who uses HCPCS code V5248?

V5248 is billed by a specific set of provider types. Understanding who typically submits this code helps practices verify their billing authority and payer relationships before submitting.

• Audiologists: The primary dispensers of hearing aids, including analog binaural CIC devices. Audiologists conduct the audiologic evaluation that typically precedes hearing aid dispensing and often submit the device claim directly.
• Hearing aid dispensers: Licensed hearing instrument specialists who dispense hearing aids without holding audiology credentials. State licensure requirements vary. Confirm dispensing authority in your state before billing.
• Otolaryngology (ENT) practices: ENT physicians may dispense hearing aids directly through in-office dispensing programs or through affiliated audiology departments.
• Durable Medical Equipment (DME) suppliers: Hearing aids are a distinct, statutorily excluded V-code benefit category within HCPCS Level II, not a DME classification. Some DME suppliers still dispense hearing devices and bill V-codes when authorized by payer contracts.

Each provider type must verify their enrollment status with the relevant payer. Medicaid enrollment requires state-specific credentialing that differs from Medicare enrollment, and billing V5248 without it is a common source of claim rejection.

Automating credentialing reminders and payer enrollment tracking inside your practice management system, such as workflow automation, reduces this risk for busy billing teams.

HCPCS code V5248 fee schedule and reimbursement rates (2026)

Fee schedule rates for V5248 vary substantially by payer and locality. The figures below are reference rates only. What a payer allows depends on your specific contract, your geographic locality adjustment, and your provider agreement’s terms.

Medicare coverage for V5248

Medicare Part B does not cover HCPCS code V5248. The exclusion is statutory, under Section 1862(a)(7) of the Social Security Act. Medicare Part B explicitly excludes hearing aids and examinations for hearing aids from covered benefits.

This exclusion applies to all routine hearing aid HCPCS V-codes, including V5248. It applies regardless of the patient’s degree of hearing loss or the clinical necessity of the device.

Two narrow exceptions exist, but they apply to very different device categories. Cochlear implants and osseointegrated hearing devices (e.g., bone-anchored hearing aids implanted surgically) may be covered under different HCPCS codes and benefit categories. Do not conflate these with conventional hearing aids billed under V5248. Billing V5248 to Medicare Part B will result in a denial.

Medicaid coverage for V5248

Medicaid coverage for V5248 varies by state, and there is no single national Medicaid rate for this code.

• Some state Medicaid plans cover hearing aids for both adult and pediatric beneficiaries.
• Other states cover hearing aids only for pediatric patients.
• Some states provide no hearing aid benefit at all.

Before billing V5248 to Medicaid, verify coverage with your state Medicaid agency. Most state Medicaid programs also require prior authorization for hearing aid dispensing, tied to a recent audiologic evaluation.

States with an established adult hearing aid benefit publish their own allowed amounts. Check Medicaid.gov and your state agency’s fee schedule for the current rate.

Private payers, including commercial insurers and managed care organizations, may cover V5248 under hearing aid benefit riders. Coverage terms, copayment levels, and frequency limitations differ widely across plans, so always verify eligibility and benefits before dispensing.

Practices managing HIPAA compliance alongside their billing workflows benefit from a single system that documents both the clinical encounter and the claim.

V5248 billing guidelines and documentation requirements

Clean claims for HCPCS code V5248 require a complete documentation trail before the device is dispensed. Payers auditing hearing aid claims look for specific elements at each stage of the dispensing workflow.

Required documentation

• Audiologic evaluation: A recent audiogram (typically within the prior 6-12 months, depending on payer) demonstrating the degree and configuration of hearing loss. The evaluation must be performed by or under the supervision of a licensed audiologist.
• Prescription or dispensing order: Some payers and state Medicaid plans require a physician prescription for hearing aid dispensing. Verify whether a written order from a physician or the audiologist’s own dispensing order is sufficient for the specific payer.
• Trial or fitting documentation: Notes documenting the hearing aid fitting, including the device make, model, and serial number. Include ear(s) fitted and any fitting protocols used (e.g., real ear measurement).
• Device description matching the billed code: The documentation must confirm the device is analog, binaural (both ears), and completely-in-canal. Any mismatch between the dispensed device and the billed code is a coding error.
• Prior authorization (payer-specific): Medicaid and many commercial plans require prior authorization before dispensing. Document the authorization number on the claim form. Submitting without a required authorization number guarantees denial.

Maintaining well-organized medical forms and documentation at your healthcare practice is the foundation of clean audiology billing. Systems that link the clinical record to the claim record reduce the risk of missing documentation at audit time. Explore digital forms to standardize audiologic intake and dispensing records across your team.

Modifiers and units of service for V5248

Binaural hearing aid codes are designed to represent a bilateral fitting in a single claim line. The accepted billing convention, consistent with ASHA guidance, is to bill V5248 as 1 unit of service. The binaural code already encodes both ears in its description.

LT (left side) and RT (right side) modifiers are generally not used with binaural hearing aid codes, because the binaural designation makes side-specific modifiers redundant. However, payer policies differ, and some commercial payers and state Medicaid programs have their own modifier rules.

Check your payer’s specific coding guidelines before submitting. Incorrect modifier usage on a binaural code is a known denial trigger. When in doubt, contact the payer’s provider relations line or refer to the PGM HCPCS lookup to cross-reference current payer edits.

How Pabau supports audiology and hearing aid billing

Audiology practices bill HCPCS codes like V5248 alongside CPT audiologic evaluation codes. They need a system that documents both code types in one place and keeps that documentation linked to what the team submits.

Practice management software like Pabau supports HCPCS code entry alongside CPT codes within the same clinical encounter. Audiologists can document the hearing aid fitting without switching between systems.

Pabau links the clinical record directly to the billing record. The audiologic evaluation notes and device details stay connected to the claim your team files. This matters at audit time, when payers request documentation supporting the billed HCPCS code.

Digital intake and assessment forms capture the audiologic history, device prescription details, and patient consent in structured fields. Workflow automation can also flag encounters that need prior authorization before the device is dispensed, reducing after-the-fact denials.

Audiology often sits alongside other specialties in the same practice. Pabau supports those adjacent workflows too, from speech therapy software to occupational therapy software, for practices offering both services under one roof.

Streamline your audiology billing documentation

Pabau links clinical documentation to HCPCS code entries in a single workflow, keeping your billing team's records organized and audit-ready.

Book a demo

Conclusion

Most V5248 denials trace back to billing the wrong payer, a missing authorization number, or the wrong device configuration. Check payer coverage before you dispense the device, and confirm every documentation element sits in the chart before you submit the claim.

Getting this right the first time costs less than reworking a denial after the fact. A system that keeps the audiologic evaluation, device details, and billing record connected makes that possible. Book a demo to see how Pabau keeps hearing aid billing documentation organized and audit-ready for your audiology practice.

Continue your research

Need a consent form for a pediatric hearing aid patient? Medical release form for a minor gives your front desk a ready-to-use release document.

Cross-referencing another supply code on the same claim? HCPCS code A4320 breaks down the fee schedule and billing rules for a related Level II code.

Billing a different HCPCS code this week? HCPCS code C1886 covers the reimbursement rules and documentation requirements for that code.

Looking up a durable medical equipment code? HCPCS code E0144 explains the coverage rules for that DME code.

Need to check a related supply code before you submit? HCPCS code A4674 walks through the billing and documentation requirements.

Frequently Asked Questions