HCPCS Code V5267: Hearing aid or assistive listening device, supplies, or accessories, NOS

V5267 should be used only when a more specific HCPCS code cannot describe a hearing aid, assistive listening device, or accessory. It applies to custom or non-standard parts such as unique connectors or specialized ear mold inserts. Standard items, such as disposable batteries or basic ear molds, usually have their own dedicated codes.

Claims should include detailed documentation such as the manufacturer’s name, model or part number, and an invoice or catalog page showing the wholesale cost. Records must also explain why the item is medically necessary for the patient’s device. Some payers, especially Medicaid programs, may require prior authorization, such as a TAR or SAR.

Reimbursement for V5267 varies by payer and is not standardized. It may be based on a contracted fee schedule, a cost-plus formula, or the lesser of the billed charge and the payer’s allowable amount. Providers must include cost details, proper modifiers, and all required documentation to support payment.