V5264 Ear mold/insert
Also known as: ear mold, earmold, ear insert
Ear mold or earmold insert custom-fabricated to fit the patient's ear canal for hearing aid coupling.
In Plain Language
custom ear insert for hearing aid; hearing aid ear piece
Clinical Context
Custom-made earmold or insert used to properly couple hearing aids to the ear canal, ensuring acoustic seal and comfort.
RVU Information
CPT V5264 does not have a physician work RVU assigned by CMS. This is typical for supply, drug, and equipment codes — reimbursement is based on Average Sales Price (ASP), fee schedules, or payer contracts rather than the RVU system.
Billing & Documentation
V-codes cover vision services, supplies, and equipment including lenses, frames, and hearing aids. A valid prescription from an authorized provider is required. Document the specific product dispensed, measurements, and clinical indication.
Specialties
Frequently Asked Questions
What is CPT code V5264?
CPT V5264 (Ear mold/insert) is a V Codes (Vision) code. Ear mold or earmold insert custom-fabricated to fit the patient's ear canal for hearing aid coupling.
Does Medicare cover V5264?
Medicare coverage for V5264 depends on medical necessity and applicable Local Coverage Determinations (LCDs). Custom-made earmold or insert used to properly couple hearing aids to the ear canal, ensuring acoustic seal and comfort. A physician order is typically required.
When is CPT V5264 used?
Custom-made earmold or insert used to properly couple hearing aids to the ear canal, ensuring acoustic seal and comfort.
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CPT® is a registered trademark of the American Medical Association. Data sourced from CMS Physician Fee Schedule RVU26A. Descriptions, synonyms, and clinical context are original content by RVU Edge.