Summary & Overview
HCPCS V5285: Assistive Listening Device, Personal FM/DM Receiver
HCPCS Level II code V5285 designates an assistive listening device component: a personal FM/DM direct audio input receiver. These receivers are part of assistive listening systems that improve access to speech and audio for individuals with hearing impairment, supporting communication in clinical, educational, and community settings. Nationally, coverage and payment for assistive listening devices influence access to hearing support technologies and rehabilitation services.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of what V5285 represents, payer coverage patterns, and the clinical contexts where personal FM/DM receivers are used. The publication covers benchmarks for utilization and reimbursement where available, outlines relevant policy considerations affecting device coverage, and summarizes clinical indications and typical service settings for the device.
The analysis is intended to inform billing, coding, and policy stakeholders about how V5285 is classified and applied across common payer environments, highlight nationwide implications for access to assistive listening technology, and identify areas where further policy clarity or payer guidance may be relevant. Data not available in the input will be noted where applicable.
Billing Code Overview
HCPCS Level II code V5285 describes an assistive listening device, personal FM/DM, direct audio input receiver. This code covers a personal receiver component used with FM (frequency modulation) or DM (digital modulation) assistive listening systems to deliver audio directly to a user via a direct audio input connection.
Service Type: Assistive listening device — personal FM/DM receiver
Typical Site of Service: Outpatient clinics, audiology offices, schools, community health settings, and patient homes
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Clinical & Coding Specifications
Clinical Context
A 68-year-old patient with bilateral sensorineural hearing loss and difficulty understanding speech in noisy environments is referred by an otolaryngologist to an audiology clinic for assistive listening options. The audiologist performs a diagnostic audiogram and speech-in-noise testing, documents functional communication limitations, and determines the patient would benefit from a personal FM/DM receiver with direct audio input to interface with hearing aids or cochlear implants. The clinic orders and dispenses the V5285 assistive listening device, programs the receiver to the patient’s assistive transmitter, provides device orientation and basic troubleshooting, and documents the device model, serial number, trial period, and patient consent. Follow-up visits are scheduled to assess benefit and make adjustments; return to the supplier occurs if the device is trialed and not beneficial. Typical sites of service include outpatient audiology clinics, durable medical equipment suppliers, and hospital-based audiology departments. Billing is submitted by the supplying provider or DME company using V5285 with appropriate modifiers reflecting circumstances of the service and payer requirements.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when the supplier documents a substantially greater level of service or complexity in device fitting or customization beyond usual. |