CurrentUnitedHealthcarePolicy N/A

Monaural Hearing Aid billing with anatomical modifiers

This policy governs how Monaural Hearing Aids are reported on the CMS-1500 form for UnitedHealthcare Individual Exchange products, specifying proper HCPCS codes, anatomical modifiers, and units of service; it affects providers billing Individual Exchange plans.

Policy Summary

PayerUnitedHealthcare

PolicyMonaural Hearing Aid billing with anatomical modifiers

Policy CodePolicy N/A

Change TypeNo material changes

Effective DateN/A

Next Review DateN/A

Key ActionBill each monaural hearing aid on its own claim line with the appropriate HCPCS code and anatomical modifier LT or RT and 1 unit of service.

SourceLink

POLICY UPDATE CHANGES

No material clinical or coverage changes in this revision.

1unit of service required per claim line for monaural hearing aid

RT or LTanatomical modifiers required

rejectedclaim lines billed without RT/LT or billed with RTLT will be

All states except MA, NV, NYapplicability of Individual Exchange benefit plans

5/25/2025most recent history/anniversary review date listed

Monaural Hearing Aid Coverage & Billing Rules

Monaural Hearing Aid coverage and billing rules

Billing and claim-line requirements for Monaural Hearing Aids on UnitedHealthcare Individual Exchange products.

Each monaural hearing aid must be billed on its own claim line with the appropriate HCPCS code and an anatomical modifier (LT or RT).

Each claim line for a monaural hearing aid must report 1 unit of service (UOS).

Do not bill monaural hearing aids using the RTLT modifier on a single claim line; RTLT is not acceptable for monaural devices.

Claim lines billed without the RT and/or LT modifiers or billed with the RTLT modifier on a single claim line will be rejected as incorrect coding.

When billing monaural hearing aids for both ears, submit separate claim lines for each device, using RT on one line and LT on the other, each with 1 UOS.

Policy Summary

PayerUnitedHealthcare

PolicyMonaural Hearing Aid billing with anatomical modifiers

Policy CodePolicy N/A

Change TypeNo material changes

Effective DateN/A

Next Review DateN/A

Key ActionBill each monaural hearing aid on its own claim line with the appropriate HCPCS code and anatomical modifier LT or RT and 1 unit of service.

SourceLink

On This Page

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

HCPCS Codes and Units of Service

Monaural Hearing Aid HCPCS codesHCPCSCovered

V5030	Monaural hearing aid HCPCS code (listed)
V5040	Monaural hearing aid HCPCS code (listed)
V5050	Monaural hearing aid HCPCS code (listed)
V5060	Monaural hearing aid HCPCS code (listed)
V5171	Monaural hearing aid HCPCS code (listed)
V5172	Monaural hearing aid HCPCS code (listed)
V5181	Monaural hearing aid HCPCS code (listed)
V5190	Monaural hearing aid HCPCS code (listed)
V5242	Monaural hearing aid HCPCS code (listed)
V5243	Monaural hearing aid HCPCS code (listed)

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Units per claim line for Monaural Hearing Aid

Unit of service per claim line1 unit of service (UOS) required for each monaural hearing aid claim line

When billing bilateral monaural aidsSubmit separate claim lines for each ear; each line must have 1 UOS

Incorrect unit reportingDo not combine units for two monaural aids on a single line; each device requires its own line with 1 UOS

Billing Requirements and Provider Actions

Billing Rule

Bill each monaural hearing aid on its own claim line with LT or RT and 1 UOS

Bill each monaural hearing aid on its own claim line with the appropriate HCPCS code and an anatomical modifier of LT or RT and 1 unit of service (UOS). Do not bill monaural hearing aids using the RTLT modifier, and do not submit claim lines without the RT or LT modifier; claim lines billed without RT/LT or billed with RTLT on a single claim line will be rejected as incorrect coding.

Submit one claim line per monaural device with 1 UOS.
Use LT for left-ear devices and RT for right-ear devices; do not use RTLT.
For bilateral monaural aids, submit two separate claim lines: one with RT and one with LT, each with 1 UOS.

Key Terms and Definitions

Anatomical Modifiers

DefinitionAnatomical modifiers designate the area or part of the body on which the procedure is performed and assist in prompt, accurate adjudication of claims.

Role in adjudicationModifiers (e.g., LT or RT) identify the ear treated to ensure correct claim processing and prevent misallocation of services

Required practiceUse LT or RT on each monaural hearing aid claim line; do not use RTLT on a single claim line

Hearing Aid

DefinitionHearing Aids are sound-amplifying devices designed to aid people who have a hearing impairment.

TechnologyMost hearing aids share similar electronic components; amplification technology may be analog or digital.

PurposeIntended to improve hearing function for individuals with hearing impairment

Monaural

DefinitionMonaural: relating to or affecting one ear.

Billing implicationClaims for monaural devices must identify the specific ear (LT or RT) on the claim line

ContrastNot bilateral; bilateral devices require separate monaural claim lines for each ear