Summary & Overview
HCPCS V5284: Assistive Listening Device, Ear-Level Receiver
HCPCS Level II code V5284 designates a personal, ear-level receiver for FM/DM assistive listening systems used to aid individuals with hearing impairment. These devices are durable medical equipment that support speech comprehension in challenging listening environments and are commonly supplied through audiology clinics, schools, and outpatient providers. Nationally, V5284 is relevant for coverage determinations and benefit design related to hearing assistive technologies, impacting access for beneficiaries who rely on wireless systems for communication.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the code’s clinical purpose and expected sites of service, plus benchmarking and policy context where available. The publication outlines common billing considerations, payer coverage patterns, and coding relationships relevant to DME and audiology service lines. The report also highlights where input data were available or not, and directs readers to technical details for claims processing and documentation expectations. This summary is intended to inform administrators, billing professionals, and clinical staff about the role of V5284 in supporting hearing care services at a national level.
Billing Code Overview
HCPCS Level II code V5284 represents an assistive listening device, personal FM/DM, ear level receiver. This item is a personal, ear-level receiver intended to amplify and transmit sound for individuals with hearing impairment, typically used with FM or DM wireless systems to improve speech understanding in noisy environments or at a distance.
Service Type: Durable medical equipment / Assistive listening device
Typical Site of Service: Outpatient clinics, audiology offices, schools, community settings, and home use, where individuals receive hearing support or auditory rehabilitation services.
Clinical & Coding Specifications
Clinical Context
A 68-year-old patient with moderate-to-severe sensorineural hearing loss and difficulty understanding speech in noisy environments is evaluated by an audiologist after referral from their primary care physician. The audiologist performs pure-tone audiometry and speech-in-noise testing, determines that the patient benefits from an assistive listening system, and recommends a personal FM/DM ear-level receiver system coded as V5284. The clinical workflow includes: an audiologic evaluation, selection and fitting of the ear-level receiver and transmitter system, patient education on device use and maintenance, verification of benefit with real-world or clinic-based speech-in-noise measures, and documentation of medical necessity for coverage. Follow-up visits address device troubleshooting, earmold or tip adjustments, and verification of ongoing benefit. Typical sites of service are an outpatient audiology clinic, otolaryngology office, or a licensed hearing aid dispenser facility when working in conjunction with a clinician-led assessment.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work required to fit or customize the device is substantially greater than usual. |
23 |