HCPCS Code V5160: Dispensing Fee, Binaural

HCPCS code V5160 is defined as the "Dispensing fee, binaural" hearing aids. It represents the professional fee associated with dispensing a pair of hearing aids (one for each ear). While V5160 applies explicitly to hearing aids, it does not cover the cost of the devices themselves or any separate assistive listening device, which would be billed under its own code.

Original Medicare (Part A and B) does not cover hearing aids or their dispensing fees, including HCPCS code V5160. Coverage for the binaural dispensing fee associated with hearing aids under V5160 is typically available only through Medicare Advantage plans, state Medicaid programs, or private insurers, not through Original Medicare. Providers should verify payer-specific coverage policies before billing this code.

HCPCS code V5160 is billed as one unit for the dispensing fee of binaural hearing aids, listing diagnosis codes for both ears. It includes up to one conformity evaluation and two follow-up visits during the trial period. Providers must submit proper documentation and bill on CMS-1500 or equivalent.