Audiology Billing Services

Audiology billing sits between two worlds. Diagnostic hearing and balance tests are usually billed to medical insurance, while hearing aids are often paid by the patient, a separate benefit, or a hearing aid network. Knowing which side of that line a service falls on decides who gets the claim.

Medicare adds another layer. It generally covers medically necessary diagnostic tests when a physician or other practitioner orders them, but it does not generally cover routine hearing aids. Westmont connects audiology practices with vetted billing experts who know these rules. They help clinics verify benefits, bill the right party, and keep orders and documentation in order, so audiology medical billing does not take time away from patient care.

Who this is for

• Independent audiology practices
• Audiologists inside ENT physician groups
• Hospital and university audiology clinics
• Hearing aid dispensing practices with a diagnostic side
• Balance and vestibular testing clinics
• Pediatric audiology programs and cochlear implant centers

What gets billed

• Pure tone and speech audiometry
• Comprehensive hearing evaluations
• Middle ear testing such as tympanometry
• Otoacoustic emissions testing
• Hearing aid evaluation and selection visits
• Hearing aid checks and follow-up
• Auditory processing evaluation
• Balance and vestibular testing
• Programming and evaluation for cochlear implants and other implanted devices
• Hearing aids and related devices, where a plan pays

Commonly billed codes

Code	Type	What it covers
92550	CPT	Tympanometry and reflex testing together
92557	CPT	Comprehensive hearing test with air, bone, and speech
92567	CPT	Tympanometry on its own
92587	CPT	Limited otoacoustic emissions test
92588	CPT	Comprehensive otoacoustic emissions test
92590	CPT	Hearing aid exam and selection, one ear
92591	CPT	Hearing aid exam and selection, both ears
92620	CPT	Evaluation of central auditory function, first hour
92626	CPT	Evaluation of auditory function for a surgically implanted device, first hour
92540	CPT	Basic vestibular evaluation battery
H90.3	ICD-10-CM	Sensorineural hearing loss, both ears
H93.13	ICD-10-CM	Tinnitus, both ears

Note

Codes are examples for orientation, not a complete list, and do not guarantee coverage or payment. Always check current code sets and payer policy.

Billing challenges in audiology

Orders and referrals. Medicare generally expects an order from a physician or other qualified practitioner for diagnostic testing. Billers confirm the order exists before testing and is kept in the chart.

Diagnostic versus routine. A test done for a medical complaint is treated differently from one done as a routine screening or to fit a hearing aid. Billers match the diagnosis to the reason for the test.

Hearing aid benefits. Hearing aid coverage is separate from medical coverage. It may come through a plan rider, a hearing aid network, or no coverage at all. Billers verify this up front and help set clear patient expectations.

Bundled test pairs. Some tests are combined into one code, and billing the parts separately leads to denials. Billers know which pairs payers treat as bundled.

Bilateral and repeat testing. Some codes already include both ears, and others are billed per ear. Billers read each descriptor and payer policy to avoid duplicates.

Medicare Advantage and commercial variation. Plans differ on authorization, in-network hearing vendors, and who may bill. Billers track each contract.

Documentation. Test results, interpretation, and medical necessity must be in the chart. Billers prompt clinicians when something is missing before the claim goes out.

How Westmont can help

• Matching your practice with vetted billing experts experienced in audiology billing
• End-to-end revenue cycle support, from verification to payment posting
• Denial management for order, bundling, and medical necessity issues
• Credentialing and enrollment help for audiologists and new locations
• Separate handling of hearing aid sales and diagnostic claims

Frequently asked questions

Does Medicare cover hearing tests?

Medicare generally covers diagnostic hearing and balance tests when a physician or other qualified practitioner orders them for a medical reason. It does not generally cover routine hearing exams for hearing aids or the hearing aids themselves, though some Medicare Advantage plans do. Check current Medicare rules and plan details.

Who pays for hearing aids?

It depends on the plan. Many health plans do not cover them, some offer a benefit through a hearing aid network, and some Medicare Advantage plans include allowances. Verifying benefits before fitting lets the clinic quote the patient an accurate cost and avoid billing the wrong payer.

Can an audiologist bill insurance for a hearing aid fitting visit?

Sometimes. Codes exist for hearing aid examination and selection, but many plans do not pay for them or bundle them into the device price. The answer depends on the plan, so confirm before the visit and document clearly what was done.

Why are audiology claims denied?

Typical reasons include missing orders, tests billed in bundled pairs, services seen as routine, diagnoses that do not support the test, and no benefit for hearing aids. An audiology billing company can sort denials into patterns and fix the front-end steps that cause them.

Do you help with ENT and audiology groups that share billing?

Often, yes. Shared groups need clear rules for who bills what and under which provider number. Let us know how your group is set up, and we will look for billing experts who have worked in similar arrangements.

Related billing services

• Otolaryngology (ENT)
• Speech-Language Pathology
• Neurodiagnostics
• Pediatrics
• Geriatrics