G0062 Audiology MIPS | HCPCS Reimbursement

HCPCS Level II code G0062 denotes the Audiology MIPS specialty set, used to identify audiology-related measures for clinicians participating in federal and private quality reporting programs. Nationally, this code matters as a marker for audiology services tied to performance measurement and value-based payment pathways, helping ensure standardized reporting across outpatient audiology settings. Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of the code's clinical context and role in quality programs, descriptions of typical sites of service and service type, and what is commonly included in analyses of such codes (benchmarks, payer coverage patterns, and relevant policy updates). The summary outlines the operational purpose of G0062 in quality reporting and its intersection with national payer programs. The publication also points to where readers can find benchmarks, reimbursement guidance, and coding advice for integrating audiology MIPS measures into clinical workflows. Data not available in the input is noted where specific payer policies, modifiers usage rates, associated taxonomies, ICD-10 mappings, related codes, and service-line details would normally appear.

Billing Code Overview

HCPCS Level II code G0062 represents the Audiology MIPS specialty set, a billing designation tied to measurement and reporting activities for audiology clinicians participating in quality reporting programs. The service type is audiology quality reporting/measure set, and the typical site of service is audiology clinics or outpatient audiology settings.

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Clinical Context

An adult or pediatric patient referred to an audiology clinic for measurement of hearing function and quality metrics associated with the MIPS Audiology Specialty Set (G0062). Typical presentation includes subjective hearing loss, tinnitus, difficulty understanding speech in noise, or monitoring of hearing status after ototoxic exposure or ear surgery. The clinical workflow begins with intake and history focused on hearing concerns and relevant medical history, followed by otoscopic inspection, tympanometry if indicated, and a comprehensive audiometric test battery (pure tone air and bone conduction thresholds, speech recognition thresholds, word recognition testing, and immittance testing). Results are documented in the patient record and submitted as part of quality reporting for the Merit-based Incentive Payment System (MIPS) Audiology Specialty Set using billing code G0062. Counseling on results, recommendations for amplification, referral to ENT or cochlear implant programs, and reporting of relevant quality measures complete the encounter. Typical sites of service include outpatient audiology clinics, hospital-based audiology departments, and physician offices with audiology services.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when billing only the professional component of an audiology service when the technical component is billed separately.

Taxonomy Code	Specialty	Notes
`228100000X`	Otolaryngology (ENT)	ENTs often refer for and co-manage audiology testing and interpretations.
`261QQ0500X`	Audiology	Primary specialty performing diagnostic audiometric testing and reporting for `G0062`.
`103T00000X`	Speech-Language Pathology	May be involved for speech discrimination testing and auditory rehabilitation notes.
`207R00000X`	Physician Assistant	Commonly performs testing under physician supervision or documents clinical components.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`H90.3`	Sensorineural hearing loss, bilateral	Common indication for comprehensive audiologic testing and quality reporting under the audiology MIPS set.
`H90.5`	Mixed conductive and sensorineural hearing loss, bilateral	Indicates mixed pathology requiring both audiometry and immittance testing to characterize middle ear and cochlear components.
`H90.41`	Sensorineural hearing loss, unilateral, right ear, with unrestricted hearing on the left	Unilateral hearing loss prompts diagnostic audiometry and possible further objective testing.
`H91.2`	Tinnitus, unspecified	Tinnitus frequently co-occurs with hearing complaints and is assessed during audiologic evaluation.
`H69.0`	Acute serous otitis media	Middle ear effusion affects audiometric thresholds; tympanometry and audiometry are indicated.
`Z96.2`	Presence of cochlear implant status	Patients with implants require specialized audiologic assessment and quality tracking in MIPS reporting.
`Z46.1`	Encounter for fitting and adjustment of hearing aid	Indicates post-diagnostic device management visits integral to audiology care pathways.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`92557`	Comprehensive audiometry threshold evaluation and speech recognition (pure tone and speech audiometry)	Common diagnostic test performed alongside the MIPS audiology quality reporting; provides primary audiometric data used for measure reporting.
`92567`	Tympanometry and reflex threshold measurements	Often performed before or during audiologic assessment to evaluate middle ear function and reflexes relevant to test interpretation.
`92562`	Conditioning/habituation and/or ascend/descend pure tone air threshold testing for the determination of thresholds	Used when behavioral testing requires special techniques (pediatric or inconsistent responders) as part of comprehensive audiologic evaluation.
`92626`	Evaluation of auditory rehabilitation; fitting and adjustment of hearing aid(s)	May follow diagnostic testing when results indicate amplification is appropriate; documented as part of the continuum of audiology care.
`92700`	Electrocochleography, auditory brainstem response (ABR) testing	Performed when objective physiologic measure is required (e.g., newborn screening follow-up, neurologic concerns) and complements diagnostic audiometry for MIPS reporting.

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Summary & Overview

HCPCS G0062: Audiology MIPS Specialty Set