Modifier/Code List
CMS established a new modifier, AB, for audiologists to use that describes: audiology service furnished personally by an audiologist without a physician/NPP order for non-acute hearing assessment unrelated to disequilibrium, or hearing aids, or examinations for the purpose of prescribing, fitting, or changing hearing aids; service may be performed once every 12 months, per beneficiary. This will allow for better accuracy of reporting and reduce burden for audiologists.
For dates of service on or after 1/1/2023, audiologists may elect to use modifier AB, along with any of the 36 CPT codes on the finalized list below but only when the beneficiary has directly accessed the audiologist.
There will be times the audiologist will bill for these services, as appropriate, without modifier AB appended, when the beneficiary presents with an order from their treating physician or NPP.
Reminder: The AB modifier is not applicable to the remainder of the codes on the Audiology Services code list.
Audiology Code List
| CPT/HCPCS | Short Descriptor | Modifier AB Allowed |
|---|---|---|
| 92550 | Tympanometry & reflex threshold | Yes |
| 92552 | Pure tone audiometric air | Yes |
| 92553 | Audiometry air & bone | Yes |
| 92555 | Speech audiometry threshold | Yes |
| 92556 | Speech audiometry complete | Yes |
| 92557 | Comprehensive hearing test | Yes |
| 92562 | Loudness balance test | Yes |
| 92563 | Tone decay hearing test | Yes |
| 92565 | Stenger test, pure tone | Yes |
| 92567 | Tympanometry | Yes |
| 92568 | Acoustic reflex testing, threshold | Yes |
| 92570 | Acoustic immittance testing | Yes |
| 92571 | Filtered speech test | Yes |
| 92572 | Staggered spondaic word test | Yes |
| 92575 | Sensorineural acuity level test | Yes |
| 92576 | Synthetic sentence id test | Yes |
| 92577 | Stenger test, speech | Yes |
| 92579 | Visual audiometry | Yes |
| 92582 | Conditioning play audiometry | Yes |
| 92583 | Select picture audiometry | Yes |
| 92584 | Electrocochleography | Yes |
| 92587 | Evoked auditory test limited w/ interpretation & report | Yes |
| 92587 – TC | Evoked auditory test limited | Yes |
| 92587 – 26 | Evoked auditory test limited | Yes |
| 92588 | Evoked auditory test complete w/interpretation and report | Yes |
| 92588 – TC | Evoked auditory test complete | Yes |
| 92588 – 26 | Evoked auditory test complete | Yes |
| 92601 | Cochlear implant f/up exam, pt <7 years of age | Yes |
| 92602 | Reprogram cochlear implant, pt <7 years of age | Yes |
| 92603 | Cochlear implant f/up exam, pt ≥7 years of age | Yes |
| 92604 | Reprogram cochlear implant, pt ≥7 years of age | Yes |
| 92620 | Auditory function test w/report, initial 60 minutes | Yes |
| 92621 | Auditory function test w/report, additional 15 minutes | Yes |
| 92622 | Diagnostic analysis, programming and verification of an auditory osseointegrated sound processor, any type; first 60 minutes | Yes, effective 1/1/2024 |
| 92633 | Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; each additional 15 minutes (List separately in addition to code for primary procedure) | Yes, effective 1/1/2024 |
| 92625 | Tinnitus assessment | Yes |
| 92626 | Eval aud function surgical, first hour | Yes |
| 92627 | Eval aud function surgical, each additional 15 min | Yes |
| 92640 | Aud brainstem implt program, per hour | Yes |
| 92651 | AEP, broadband, w/ inter & report | Yes |
| 92652 | AEP, threshold estimation w/inter & report | Yes |
| 92653 | AEP, threshold, dx w/inter & report | Yes |
The 14 CPT codes for vestibular function tests – for which codes billed with the AB modifier will be rendered unpayable.
| CPT/HCPCS | Short Descriptor | Modifier AB Allowed |
|---|---|---|
| 92517 | cVEMP, cervical w/inter & report | No |
| 92518 | oVEMP, ocular w/inter & report | No |
| 92519 | VEMP, cervical and ocular w/inter & report | No |
| 92537 | Caloric vstblr test w/rec | No |
| 92537 – TC | Caloric vstblr test | No |
| 92537 – 26 | Caloric vstblr test | No |
| 92538 | Caloric vstblr test w/rec | No |
| 92538 – TC | Caloric vstblr test | No |
| 92538 – 26 | Caloric vstblr test | No |
| 92540 | Basic vstblr evaluation | No |
| 92540 – TC | Basic vstblr evaluation | No |
| 92540 – 26 | Basic vstblr evaluation | No |
| 92541 | Spontaneous nystagmus test | No |
| 92541 – TC | Spontaneous nystagmus test | No |
| 92541 – 26 | Spontaneous nystagmus test | No |
| 92542 | Positional nystagmus test | No |
| 92542 – TC | Positional nystagmus test | No |
| 92542 – 26 | Positional nystagmus test | No |
| 92544 | Optokinetic nystagmus test | No |
| 92544 – TC | Optokinetic nystagmus test | No |
| 92544 – 26 | Optokinetic nystagmus test | No |
| 92545 | Oscillating tracking test, with recording | No |
| 92545 – TC | Oscillating tracking test, with recording | No |
| 92545 – 26 | Oscillating tracking test, with recording | No |
| 92546 | Sinusoidal rotational test | No |
| 92546 – TC | Sinusoidal rotational test | No |
| 92546 – 26 | Sinusoidal rotational test | No |
| 92547 | Supplemental electrical test | No |
| 92548 | CDP-SOT 6 cond w/interpretation & report | No |
| 92548 – TC | CDP-SOT 6 cond | No |
| 92548 – 26 | CDP-SOT 6 cond | No |
| 92549 | CDP-SOT 6 cond w/MCT and ADT w/interpretation & report | No |
| 92549 - TC | CDP-SOT 6 cond w/MCT and ADT | No |
| 92549 - 26 | CDP-SOT 6 cond w/MCT and ADT | No |
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Revised 4/9/2024