HCPCS code V5298 – Hearing aid not otherwise classified

Key takeaways

HCPCS Code V5298 is the not otherwise classified code for a hearing aid that no specific HCPCS device descriptor fits.

Medicare Part B excludes routine hearing aids by statute, so V5298 almost never produces a Part B payment.

Payers price V5298 from the manufacturer or supplier invoice, so a claim sent without it is likely to be denied.

Supplies and accessories bill under V5267 and hearing services under V5299, so neither belongs on V5298.

Pabau’s claims management software checks claims for missing details and sends them with the invoice attached.

HCPCS Code V5298: Definition and code family context

HCPCS Code V5298 is the Level II code for a hearing aid, not otherwise classified. The Centers for Medicare & Medicaid Services (CMS) maintains it in the V5xxx hearing services section, alongside the codes in our HCPCS billing guides. The full official descriptor is Hearing aid, not otherwise classified.

The hearing services range runs from V5008 through V5364 and covers hearing assessments, fittings, dispensing fees, devices and supplies. Within it, specific device codes describe a hearing aid by ear, wearing style and circuit type. V5298 is the not otherwise classified (NOC) code, so it takes any hearing aid that none of those specific descriptors fits.

What V5298 covers and what it excludes

V5298 applies to a hearing aid dispensed to a patient when no other hearing aid code accurately describes the device. Use it for new hearing technology, hybrid devices that combine amplification with other features, or an instrument with no specific HCPCS descriptor.

Covered under V5298:

• Hearing aids whose ear, style and circuit combination no specific V5xxx device code describes
• Emerging or experimental amplification devices dispensed outside a clinical trial
• Manufacturer-proprietary instruments that lack a CMS-assigned specific code
• Custom-configured hearing aids combining several technologies when no specific code fits

Not covered under V5298:

• Any hearing aid with an existing, more specific descriptor. Billing V5298 for it misstates the device and triggers a denial.
• Purely cosmetic ear devices, such as decorative earpieces with no amplification function
• Cochlear implant devices and processors, which have dedicated L8614 and L8619 codes
• Personal sound amplification products (PSAPs) sold over the counter, which are consumer electronics rather than medical devices
• Hearing aid supplies, accessories and assistive listening devices, which bill under V5267

V5298 vs other hearing aid HCPCS codes: When to use each

The most common billing error with HCPCS Code V5298 is using it when a more specific code exists. The table below maps the neighboring codes coders confuse most often, so you can confirm the right one before submission.

Laterality alone never sends a claim to V5298. The specific codes split by ear, by style and by circuit, so a pair of digital behind-the-ear aids bills V5261. V5267 is not a hearing aid code at all, because it covers supplies, accessories and assistive listening devices.

Work through the checks in the order below, and V5298 is only left once every specific code has been ruled out.

Medicare coverage of HCPCS Code V5298

Medicare Part B does not cover routine hearing aids. The exclusion sits in Section 1862(a)(7) of the Social Security Act, so neither CMS nor a local coverage determination (LCD) can waive it. A V5298 claim to Part B for a standard hearing aid is denied, whatever the medical necessity documentation says.

V5298 can still appear on a Medicare-adjacent claim in two narrow scenarios:

• Medicare Advantage (Part C) plans: Some MA plans offer supplemental hearing benefits. Coverage and prior authorization requirements vary by plan, so verify each plan’s benefit structure before billing.
• Skilled nursing facility (SNF) consolidated billing: A hearing device furnished during a covered Medicare SNF stay may fall under the SNF consolidated billing rate. In that case it isn’t billed separately to Part B.

When a Medicare-primary patient asks about hearing aid coverage, note in the medical record that you explained the Part B exclusion. An Advance Beneficiary Notice (ABN) isn’t required for a statutorily excluded item, but a voluntary one documents that the patient chose to pay privately.

Medicaid and commercial payer coverage for V5298

Medicaid hearing aid coverage varies by state. Some programs cover hearing aids for adults with documented hearing loss, while others limit coverage to children or exclude hearing aids entirely. Medi-Cal (California Medicaid), for example, covers certain hearing aids for eligible beneficiaries and requires prior authorization above a set cost threshold.

Commercial health plans are the most likely source of V5298 payment for adult patients. Rules differ by plan, but most commercial payers that cover hearing aids follow a similar pattern:

• Prior authorization: Most commercial plans require it for any hearing aid, including V5298. Obtain the PA before dispensing the device.
• Invoice attachment: NOC codes almost always need a manufacturer or supplier invoice with the claim. With no fee schedule amount to apply, the payer prices the claim from that invoice.
• Medical necessity documentation: A diagnostic audiogram and a physician or audiologist order are standard. Some payers also want evidence of a trial with a less expensive device.
• Benefit maximums: Many plans cap hearing aid benefits at a fixed dollar amount, or at one device per ear every 36 to 60 months. Confirm the patient’s remaining benefit before dispensing.

Fee schedule and reimbursement rates for V5298

V5298 has no published Medicare fee schedule amount, because Medicare Part B excludes routine hearing aids. Payers that do cover the code usually pay from the billed charge or the supplier invoice rather than a fixed fee schedule figure.

The table below summarizes how the most common payer types price V5298:

To set the billed charge for V5298, start with the supplier or manufacturer invoice. Bill the fitting separately under V5011, or a dispensing fee under V5090, V5110 or V5160. Keep the device charge at the invoice cost, because payers that price NOC codes by invoice will request it and adjust the claim to match.

Documentation requirements for billing V5298

NOC codes draw extra payer scrutiny because no standard code describes the device. The documentation bar for HCPCS Code V5298 sits higher than for specific hearing aid codes, and a missing element usually ends in denial. Review your medical billing compliance standards before you set up the intake workflow.

• Diagnostic audiogram: A current audiogram, typically within 12 months, documenting the type and degree of hearing loss. The performing audiologist must sign it.
• Physician or audiologist order: A written order for the hearing aid that states the clinical indication. Some payers require it from an MD or DO rather than an audiologist.
• Medical necessity statement: A narrative or structured form explaining why this device is needed and why a more commonly covered device won’t do.
• Manufacturer or supplier invoice: The document most often missing from V5298 claims. It must show the device name, model number and cost, because payers price the claim from it.
• Device description: A written description of the manufacturer, model, configuration and special features that explains why no specific code applies.
• Fitting notes: A record of the fitting appointment, including real-ear measurements or other fit verification where applicable.
• ABN (if Medicare-adjacent): A voluntary Advance Beneficiary Notice of Noncoverage when Medicare Part B won’t pay and the patient will be billed privately.

Common claim denial reasons for V5298 and how to avoid them

V5298 denials cluster around five causes, and each one is cheaper to fix at intake than after the remittance arrives. Building denial management in healthcare into the workflow before claims go out keeps audiology billing teams off the appeals treadmill.

How to submit a claim with HCPCS Code V5298

DMEPOS suppliers and audiology practices bill V5298 on the CMS-1500 claim form or its electronic equivalent, the 837P transaction. Claims management software that checks each claim before it goes out catches a missing attachment or authorization number early. Follow these steps for a clean submission.

1. Confirm no specific code applies. Check the device’s ear, style and circuit against the crosswalk table. If a specific code fits, bill it, and bill supplies or accessories under V5267 instead.
2. Obtain prior authorization. Confirm whether the patient’s plan requires PA for hearing aids. Submit the request with the audiogram and medical necessity documentation, and record the PA number before scheduling the fitting.
3. Collect the invoice. Obtain the manufacturer or distributor invoice for the specific device model before the fitting appointment.
4. Complete the CMS-1500. Enter V5298 in field 24D. Place of service is typically 11 (office) or 12 (home). Enter the PA number in field 23 if applicable, and attach the invoice.
5. Submit with full documentation. Include the audiogram, physician order, medical necessity statement, device description and invoice. Many commercial payers and state Medicaid programs want all five on first submission.
6. Track and follow up. Watch the remittance for denial reason codes. Common ones on V5298 are CO-4 (procedure code inconsistent with the modifier), CO-50 (not deemed medically necessary) and CO-96 (non-covered charge). A complete superbill prepared before submission cuts rework.
7. Appeal denied claims promptly. For a documentation denial, attach the missing items and resubmit as a corrected claim. For a non-coverage denial, check whether another payer applies or the patient must pay privately.

The AAPC’s HCPCS Level II code reference and the PGM Billing HCPCS lookup tool help you verify current descriptors and check adjacent codes before submission.

How Pabau keeps V5298 claims complete before they go out

Most audiology teams assemble a V5298 claim by hand. The audiogram sits in one folder, the supplier invoice in an inbox, and the PA number on a sticky note. Each claim then waits on someone to gather the pieces, and one missed attachment sends it back unpaid.

Pabau, the practice management platform we build, keeps claims beside the patient record, the appointment and the invoice. Background checks confirm details such as membership numbers and authorization codes before a claim leaves. In the US, claims go electronically to payers through Claim.MD, with the invoice attached.

Every claim then moves through the same stages, from pending and submitted to paid or error. Your team sees which V5298 claims are stuck and why, so they fix a missing invoice in minutes rather than weeks.

Send complete V5298 claims the first time

Pabau checks each claim for authorization codes and attaches the invoice before submission. Your team spends less time chasing hearing aid denials and more time with patients.

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Conclusion

Treat V5298 as the last code you reach for. Rule out services, supplies and every specific hearing aid code first, then bill it with the invoice and device description already attached.

Check the payer before the fitting, not after. Medicare Part B will never pay, so the patient conversation and the private-pay paperwork belong at the first visit. A practice that gets those two steps right turns V5298 from a denial risk into a routine invoice-priced claim.

Book a demo to see how Pabau keeps the invoice, authorization and audiogram together for every hearing aid claim.

Continue your research

Want to understand how the billing cycle connects to your revenue? What is revenue cycle management explains the end-to-end process from patient encounter to final payment.

Looking for a clean-claim reference before your next submission? Submitting a clean claim covers the data elements and common errors that decide whether a claim pays on first pass.

Billing a hearing service rather than a device? HCPCS code V5299 covers miscellaneous hearing services that have no specific code.

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