Blue Cross | Blue Shield | Blue Care Network of Michigan The Record

Stethoscope with RX papers

Forward to a friend  |  Subscribe  |  The Record Archive  |  Contacts  |  bcbsm.com  |  Print this article
January 2020

Balance billing allowed for nonstandard hearing aids

Effective Jan. 1, 2020, new hearing procedure codes were added to the nonstandard hearing aids list. The approved amount for standard hearing aids is payment in full, meaning you can’t bill the member for any amounts in excess of applicable copayments and deductibles.

If a member chooses a nonstandard hearing aid, you may bill for the difference between our approved amount for a standard hearing aid and the actual cost of the nonstandard hearing aid. Inform your patients that they’ll be required to pay the difference between what Blue Cross Blue Shield Michigan pays and what the nonstandard hearing aid costs.

The new nonstandard hearing aids procedure codes are:

  • V5171
  • V5172
  • V5181
  • V5211
  • V5212
  • V5213
  • V5214
  • V5215
  • V5221

Note: These codes are in addition to the list of hearing aid codes currently allowed for balance billing.

No portion of this publication may be copied without the express written permission of Blue Cross Blue Shield of Michigan, except that BCBSM participating health care providers may make copies for their personal use. In no event may any portion of this publication be copied or reprinted and used for commercial purposes by any party other than BCBSM.

*CPT codes, descriptions and two-digit numeric modifiers only are copyright 2019 American Medical Association. All rights reserved.
Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and
independent licensees of the Blue Cross and Blue Shield Association.