HCPCS Code V5020: Conformity Evaluation

Learn about HCPCS V5020 conformity evaluations for hearing aids, including billing, documentation, and payer coverage rules.

Use Code

Frequently asked questions

Use V5020 when performing a formal conformity evaluation, which involves objective verification such as real-ear measurements, speech mapping, or functional gain testing to confirm that the hearing aid conforms to prescribed targets. In contrast, CPT 92592/92593 apply to more routine hearing aid checks without formal conformance testing.

Yes. In some programs (such as Medicaid), V5020 may be billed during a defined 90-day trial period. However, coverage rules vary by state and payer. Some payers explicitly restrict billing to non-dispensing audiologists, so providers should confirm the policy before submitting claims.

Typically, non-dispensing audiologists may bill V5020, while dispensing providers may be excluded depending on payer policy. This distinction exists to avoid duplication with dispensing fees. Always check local Medicaid or commercial payer guidelines to confirm who is eligible to bill (New York State Medicaid Office of Health Insurance & Department of Health, n.d.).