Audiology Billing Services

Audiology billing splits into two worlds that follow different rules: diagnostic testing, which most payers cover when medically necessary, and hearing device services, which traditional Medicare statutorily excludes. On top of that split, the diagnostic code set is full of bundled codes, where billing the component tests separately instead of the bundled code triggers automatic denials. A practice that treats every audiology encounter as a generic office visit will lose revenue in both directions.
MedPlus RCM provides medical billing, coding, credentialing, and denial management for audiology practices, built around the specialty’s actual code families and payer requirements.

Audiology billing challenges

Diagnostic audiometry starts with pure-tone testing: 92552 for air only, 92553 for air and bone, and speech audiometry with 92555 for threshold and 92556 for threshold with speech recognition. When both air and bone thresholds and speech recognition are completed, the bundled code 92557 must be used instead of the component codes. Reporting 92553 and 92556 alongside 92557 for the same encounter violates bundling edits and leads to line-item denials, so the code must match the full battery actually performed.
Other diagnostic tests each carry their own rules. Tympanometry is reported with 92567, acoustic reflex testing with 92568, auditory brainstem response with 92585, and otoacoustic emissions with 92587 for a limited evaluation or 92588 for a comprehensive one. Vestibular testing, including the comprehensive ENG and VNG battery reported with 92540, adds another code family with its own documentation requirements. The test performed, the patient’s age, and whether components were done individually or as part of a bundled evaluation all affect code selection.
Hearing aids and related services are statutorily excluded from traditional Medicare Part B coverage, so device selection, fitting, and follow-up for Medicare patients cannot be billed to Medicare the way diagnostic testing can. Medicare Advantage plans may offer a hearing aid benefit, and Medicaid and commercial coverage varies by plan. The hearing device code set also changed: starting January 1, 2026, a new set of codes (92628 through 92642) describes hearing device services such as candidacy evaluation, selection, fitting and follow-up, and verification, replacing the longstanding 92590 through 92595 codes. Some payers may be slow to adopt the new codes, so payer policy must be checked before the new codes are used.

What MedPlus RCM handles for Audiology practices

• End-to-end medical billing. Charge entry, claim scrubbing, submission, payment posting, and patient billing, the full cycle.
• Medical coding. Certified coders assign current ICD-10, CPT, and HCPCS codes matched to your documentation and specialty.
• Provider credentialing and enrollment. End-to-end enrollment with commercial payers, Medicaid programs, and Medicare, plus re-credentialing maintenance.
• Denial management and recovery. Every denial investigated to root cause, corrected, and appealed with documentation.
• A/R recovery. Aged and outstanding balances audited and pursued, including balances already written off where the appeal window is still open.
• Financial reporting. Clean claim rates, collections, denial patterns, and A/R aging visible by payer and provider.
  We serve audiology practices nationwide, including independent clinics, ENT-affiliated practices, and practices offering diagnostic testing, vestibular evaluation, and hearing device services.

Results Audiology practices can check

MedPlus RCM maintains a 99% clean claim rate and keeps client accounts receivable under 30 days. Pricing is a performance-based percentage of successfully collected revenue: if you don’t get paid, we don’t get paid. We are 100% HIPAA compliant, and onboarding takes 2 to 4 weeks depending on practice size, with no disruption to your daily cash flow.

Frequently asked questions

Does Medicare cover hearing aids?
No. Hearing aids and related services are statutorily excluded from traditional Medicare Part B. Diagnostic audiology testing is a separate benefit and is covered when medically necessary and ordered appropriately.
What is the difference between 92557 and its component codes?
Code 92557 is the bundled comprehensive audiometry evaluation combining air and bone pure-tone testing with speech recognition. When the full battery is performed, 92557 must be billed instead of the individual component codes.
Why did our component test codes deny?
The most common cause is unbundling: reporting component codes alongside a bundled code for the same encounter. Bundling edits deny the component lines automatically.
What changed in audiology coding in 2026?
A new set of codes (92628 through 92642) replaced the older hearing device service codes (92590 through 92595). Payer adoption may vary, so coverage and code acceptance should be confirmed per payer.
What does MedPlus RCM charge?
A performance-based percentage of successfully collected revenue. If you don’t get paid, we don’t get paid.

Get a free financial audit

Find out where your audiology practice is losing revenue. Request a free financial audit and our specialists will review your claims, denials, and A/R.
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