Summary & Overview
HCPCS V5060: Monaural Behind-the-Ear Hearing Aid
HCPCS Level II code V5060 identifies a monaural, behind-the-ear hearing aid device supplied for a single ear. This code is used nationally to bill for the durable medical equipment component of hearing rehabilitation when a standalone hearing aid is provided. Accurate use of V5060 matters for device tracking, coverage determination, and claims processing across commercial and public payers.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for prescribing and supplying a monaural BTE hearing aid, common reimbursement considerations, and benchmarks used by major payers. The publication summarizes typical sites of service, coding nuances relevant to durable medical equipment claims, and common modifiers that may accompany device billing (modifier list: Data not available in the input.).
This document equips billing professionals, audiology providers, and policy analysts with the code definition, payer coverage landscape, and points of attention when processing claims for a single behind-the-ear hearing aid using HCPCS Level II code V5060. Data not available in the input.
Billing Code Overview
HCPCS Level II code V5060 denotes a monaural behind-the-ear hearing aid device. The code represents the supply of a single hearing aid intended for placement behind one ear to amplify sound for patients with hearing impairment.
Service type: Hearing aid device supply
Typical site of service: Durable medical equipment or outpatient audiology/hearing services setting
Clinical & Coding Specifications
Clinical Context
A 72-year-old patient with progressive sensorineural hearing loss presents to an audiology clinic after difficulty following conversations in quiet and noisy environments. The evaluation includes otoscopy, pure-tone audiometry, speech recognition testing, and real-ear measurements. The audiologist determines the patient is an appropriate candidate for a monaural behind-the-ear hearing aid. The workflow: initial evaluation and counseling, selection and ordering of a device described by billing code V5060 (hearing aid, monaural, behind the ear), fitting appointment with programming and verification (real-ear probe microphone measures), patient education on use and maintenance, and scheduled follow-up visits for adjustments and warranty/repair coordination. Typical site of service is an outpatient audiology clinic, hearing center, or ENT office. Typical patient scenario includes unilateral fitting when hearing loss is asymmetric, financial or insurance constraints favor single-device provision, or clinical preference for monaural amplification.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | General default when no specific modifier applies to the item billed |
22 |