Tables 1-6 see below for APC assignments, status indicators, and reimbursement amounts for audiology codes.  An “S” status indicator denotes a “Separate APC Payment” where regardless of services performed on the same date of service, the CPT code is paid at the APC rate. A “Q1” status indicator represents “STV-Packaged Codes” where APCs and CPT codes billed on the same date of service as those assigned a status indicator of “S”, “T” or “V” are packaged and not paid for separately. If billed without the “S,” “T,” or “V” service, payment is made at the APC rate. Status indicator “N” indicates payment is packaged into payment for other services, therefore no separate APC payment will be allowed. Status indicator “E1” is not paid by Medicare when submitted on outpatient claims. New CPT 92650 for 2021 (Aep scr auditory potential) has a status indicator of E1 and is not assigned to an APC.

Table 1:  APC 5721-Level I Diagnostic Tests and Related Services

(2018 final = $136.31)

(2019 final = $135.95)

(2020 final = $138.33)

(2021 final = $139.55)    

CPT CodeCode DescriptorStatus Indicator (SI) 2018 Final2019 Final2020 Final2021 Final
92537*Caloric vestibular test with recording, bilateral; bitherma (moved here from APC 5722)SSSS
92538*Caloric vestibular test with recording, bilateral; monothermal (moved here from APC 5722)SSSS
92540Basic vestibular evaluationSSSS
92544Optokinetic nystagmus test, bidirectional, foveal or peripheral stim, w/recordingpSSSS
92546Sinusoidal vertical axis rotational testingSSSS
92584ElectrocochleographySSSS
92586Auditory evoked potentials, limited (discontinued)SSS 
92601Cochlear Implant initial programming <7 years oldSSSS
92602Subsequent programming <7 years oldSSSS
92603Cochlear implant initial programming > 7 years oldSSSS
92604Subsequent programming >7 years oldSSSS
92640Auditory brainstem implant programmingSSSS
92550Tympanometry & reflex thresholdQ1Q1Q1Q1
92553Audiometry air and boneQ1Q1Q1Q1
92557Comprehensive hearing evaluationQ1Q1Q1Q1
92562Loudness balance testQ1Q1Q1Q1
92570Acoustic immitance testingQ1Q1Q1Q1
92572Staggered spondaic word testQ1Q1Q1Q1
92579Visual audiometry (VRA)Q1Q1Q1Q1
92582Conditioning play audiometryQ1Q1Q1Q1
92620Auditory function test (60 min)Q1Q1Q1Q1
92625Tinnitus assessmentQ1Q1Q1Q1
92626Evaluation of auditory rehab statusQ1Q1Q1Q1
92651Aep hearing status deter i&r NEW for 2021   S
92517Vemp test i&r cervical – NEW 2021   S
92518Vemp test i&r ocular- NEW 2021   S

Table 2:  APC 5722- Level II Diagnostic Tests and Related Services

(2018 final = $248.81)

(2019 final = $252.31)

(2020 final = $253.07)

(2021 final = $264.45) 

CPT CodeCode DescriptorSI 2018 Final2019 Final2020 Final2021 Final
92545*Oscillating tracking test with recording (moved here from APC 5721)SSSS
92585Auditory evoked potentials (ABR), comprehensive (discontinued)SSS 
92587OAEs, limitedSSSS
92588OAEs, comprehensiveSSSS
92519Vemp tst i&r cervical&ocular NEW 2021   S
92652Aep thrshld est mlt freq i&r NEW 2021   S
92653Aep neurodiagnostic i&r NEW 2021   S

Table 3: APC 5723- Level III Diagnostic Tests and Related Services

(2018 final = $444.36)

(2019 final = $455.27)

(2020 final = $485.55)

(2021 final = $487.78)            

                                                                                                                          CPT CodeCode DescriptorSI 2018 Final2019 Final2020 Final2021 Final
92577Stenger test, speechQ1Q1Q1Q1

Table 4: APC 5731- Level I Minor Procedures

(2018 final = $17.47)

(2019 final = $17.17)

(2020 final = $22.98)

(2021 final = $24.67)

CPT CodeCode DescriptorSI 2018 Final2019 Final2020 Final2021 Final
92564SISI hearing testQ1Q1Q1Q1
92700Unlisted otorhinolaryngological service or procedureQ1Q1Q1Q1

Table 5: APC 5732- Level II Minor Procedures

(2018 final = $31.80)

(2019 final = $32.12)

(2020 final = $33.43)  

(2021 final = $33.84)

CPT CodeCode DescriptorSI 2018 Final2019 Final2020 Final2021 Final
92555Speech threshold audiometryQ1Q1Q1Q1
92563Tone decay hearing testQ1Q1Q1Q1
92565Stenger test, pure toneQ1Q1Q1Q1
92567TympanometryQ1Q1Q1Q1
92568Acoustic reflex thresholdQ1Q1Q1Q1
92571Filtered speech testQ1Q1Q1Q1
92575Sensorineural acuity testQ1Q1Q1Q1
92576Synthetic sentence testQ1Q1Q1Q1
92596Ear protection measurementQ1Q1Q1Q1

Table 6:  APC 5733 – Level III Minor Procedures *NEW assignment for two audiology codes in 2021

(2021 final = $55.66)

CPT CodeCode Descriptor2021 Final
92556*Speech threshold and discrimination (moved here from APC 5732)Q1
92583*Select picture audiometry (moved here from APC 5732)Q1

Table 7: APC 5734- Level IV Minor Procedures

(2018 final =$105.03)

(2019 final = $106.48)

(2020 final = $109.02)

(2021 final = $111.95)

CPT CodeCode DescriptorSI 2018 Final2019 Final2020 Final2021 Final
92541Spontaneous nystagmus testQ1Q1Q1Q1
92542Positional nystagmus testQ1Q1Q1Q1
92548PosturographyQ1Q1Q1Q1
92552Pure tone audiometry airQ1Q1Q1Q1
92561Bekesy audiometry diagnosisQ1Q1Q1Q1
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