Summary & Overview
HCPCS V5286: Assistive Listening Device, Personal Bluetooth/FM/DM Receiver
HCPCS Level II code V5286 designates an assistive listening device: a personal Bluetooth/FM/DM receiver used to enhance communication for people with hearing impairment. As assistive technologies and remote communication tools proliferate, this code captures devices that bridge hearing aids or cochlear implants with external audio sources, supporting access in clinical, educational, and community settings. Nationally, coverage and coding for personal assistive listening receivers affect access to communication supports for beneficiaries across commercial and public payers.
Key payers in scope include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the code’s clinical role and typical sites of use, common billing modifiers associated with the service line (input provided), and gaps where input data is not available. The publication outlines benchmark considerations and policy-relevant points affecting reimbursement and documentation for assistive listening devices.
The analysis provides practical context for billing staff, audiology providers, and health plan policy teams: what V5286 represents, where it is typically used, and which payers commonly adjudicate claims for such devices. Data not available in the input is noted where relevant, including detailed payer-specific coverage rules, taxonomy mappings, and ICD-10 pairings.
Billing Code Overview
HCPCS Level II code V5286 describes an assistive listening device, personal Bluetooth FM/DM receiver. The code represents a small, wearable or portable receiver that connects wirelessly (Bluetooth, FM, or DM) to sound sources to improve speech and environmental sound access for individuals with hearing impairments.
Service Type: Durable medical equipment / assistive listening device
Typical Site of Service: Outpatient clinics, audiology offices, educational settings, and home use
Clinical & Coding Specifications
Clinical Context
A patient with documented hearing impairment and difficulty understanding speech in noisy environments is evaluated by an audiologist or otolaryngologist and is recommended an assistive listening device. The billed item is a personal Bluetooth/FM/DM receiver intended to pair with a transmitter (FM/DM system or Bluetooth source) to improve signal-to-noise ratio for speech in classrooms, work, or public settings. Typical workflow: the patient attends an audiology visit for assessment of hearing complaints and functional listening needs; the clinician performs audiometric testing and speech-in-noise evaluation, documents candidacy for an assistive listening device, programs and pairs the personal receiver with the transmitter or mobile device, provides user instruction and coupling accessories, and documents device dispensing and patient education. Follow-up visits assess fit, function, and any troubleshooting or adjustments. Typical site of service: outpatient audiology clinic, ENT clinic, school-based health services, or durable medical equipment vendor locations. Typical patient scenario: an adult or pediatric patient with sensorineural hearing loss who demonstrates poor speech understanding in background noise and benefits from a personal FM/DM or Bluetooth receiver used with a remote microphone or classroom transmitter.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when services required substantially greater effort or time than usual for device fitting, programming, or counseling documented in the record. |