Summary & Overview
HCPCS V5244: Hearing Aid, Digitally Programmable Analog, Monaural, CIC
HCPCS Level II code V5244 denotes a monaural, completely-in-canal (CIC) hearing aid that is digitally programmable with analog signal processing. The code captures a common class of discreet, custom-fitted hearing amplification used in outpatient audiology and ENT settings. Nationally, hearing aid coverage and billing for such devices matter because they intersect durable medical equipment policy, patient access to audiology services, and payer-specific coverage criteria.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication summarizes reimbursement benchmarks, typical sites of service, and clinical context for device selection. Readers will find a concise breakdown of how V5244 is classified, the service type and usual care setting, and which payers commonly appear in coverage discussions. The report also outlines common billing practices, available modifiers (listed separately), and notes where input data was not provided.
This overview is intended for providers, billing professionals, and policy analysts seeking a national-level reference on coding, clinical context, and payer landscape for monaural CIC hearing aids billed under HCPCS Level II code V5244.
Billing Code Overview
HCPCS Level II code V5244 represents a hearing aid, digitally programmable analog, monaural, completely-in-canal (CIC) device. This code describes a single-unit, in-ear hearing amplification device that is digitally programmable but uses analog signal processing, intended for patients with hearing loss who require a discreet, custom-fitted solution.
Service Type: Durable Medical Equipment / Hearing Aid Device
Typical Site of Service: Audiology clinic, hearing aid dispenser office, or ENT (ear, nose, and throat) practice
Clinical & Coding Specifications
Clinical Context
A 72-year-old patient presents to an audiology clinic complaining of progressive unilateral hearing difficulty, difficulty following conversations in groups, and trouble hearing on the affected side. The audiologist performs pure tone and speech audiometry, tympanometry, and real-ear measurements, confirming a mild-to-moderate sensorineural hearing loss in one ear suitable for a behind-the-ear or completely-in-canal style hearing device. The clinician recommends a digitally programmable analog, monaural, completely-in-canal (CIC) hearing aid coded as V5244.
The clinical workflow includes: an initial audiologic evaluation and counseling visit; device selection and ordering of the V5244 hearing aid; earmold or impressions if required for CIC fit; device programming and verification (real-ear or functional gain) at the dispensing appointment; patient education on insertion, removal, battery care, and maintenance; and a follow-up visit for amplification fine-tuning and outcome measures. Typical sites of service are outpatient audiology clinics, ENT practice offices, and specialty hearing centers. Common payors involved include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, and Medicare for eligible beneficiaries.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 |