Summary & Overview
CPT 92651: Auditory Response Test for Hearing Assessment
CPT code 92651 represents an objective diagnostic procedure that measures a patient’s response to nonspecific frequency sound stimuli to determine hearing status, with interpretation and a formal report. This code is used across outpatient audiology clinics and diagnostic facilities and matters nationally because accurate classification of hearing impairment drives clinical management, habilitation/rehabilitation planning, and appropriate allocation of follow-up services such as hearing aids or further testing.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise national overview of code intent and clinical context, typical sites of service, and the common modifiers associated with billing for this audiologic diagnostic. The publication outlines what stakeholders should expect in terms of coding purpose, documentation components, and the role of the test in patient pathways.
The analysis covers benchmark topics and policy-relevant items: typical clinical indications and reporting expectations for 92651, documentation elements that support medical necessity, payer coverage landscape highlights, and common billing modifiers used with this diagnostic service. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 92651 measures a patient’s response to nonspecific frequency sound stimuli to evaluate hearing status. The service includes interpretation and a written report of the findings.
Service type: Diagnostic auditory evoked response test (hearing assessment)
Typical site of service: Audiology clinic or outpatient diagnostic facility
Clinical & Coding Specifications
Clinical Context
A 45-year-old patient presents to an outpatient audiology clinic with complaints of progressive difficulty hearing conversations in noisy environments and intermittent tinnitus. The audiologist conducts a speech reception threshold screen and determines that diagnostic behavioral pure tone testing is indicated to quantify hearing sensitivity. The provider performs 92651 — measurement of response to nonspecific frequency sound stimuli (pure tone audiometry) — in a sound-treated booth, documents test parameters, and provides an interpretation and written report. The workflow includes check-in and history review, otoscopic ear inspection, earphone placement and calibration verification, administration of air conduction and, if appropriate, bone conduction pure-tone testing across frequencies, recording thresholds, interpreting configuration and degree of hearing loss, and communicating results to the referring clinician. The completed report is retained in the medical record and transmitted to the referring physician for management planning.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the professional interpretation and report by the physician or audiologist separate from technical performance. |