Audiology diagnostics, vestibular testing, cochlear implants, and hearing aids/devices/services are covered and paid for by using CPT/HCPCS procedure codes. Only certain hearing‑aid codes require prior authorization, and that’s usually when a patient has already used up their coverage allowance. You should check the official Florida Medicaid hearing services fee schedule to see which codes need approval.
Therefore, there is a huge amount of variability in the reimbursement amounts for these services and equipment, ranging from ($5.86) for basic audiological procedures to ($16,579.85) for implantable device component lists.
The most common Florida Medicaid hearing services fee schedule 2026 includes:
CPT Codes – Basic Audiology Testing (Low Cost: ~$5 – $32)
- 92547 – $5.86
- 92558 – $7.24
- 92567 – $9.58
- 92552 – $25.97
- 92553 – $31.50
CPT Codes – Comprehensive & Diagnostic Audiology (Mid Range: ~$16 – $60)
- 92555 – $19.54
- 92556 – $28.11
- 92557 – $26.73
- 92570 – $23.48
- 92579 – $32.22
- 92582 – $60.00
CPT Codes – Vestibular & Specialized Testing (PC/TC Split: ~$13 – $92)
- 92537 – $29.47
- 92541 – $18.48
- 92546 – $91.88
- 92587 – $16.49
- 92588 – $25.23
CPT Codes – Cochlear Implant & Advanced Services (Higher Cost: ~$15 – $115)
- 92601 – $115.40
- 92603 – $108.90
- 92620 – $66.19
- 92630 – $63.34
- 92621 – $15.74
HCPCS Codes – Hearing Aids & Related Services (V Codes | Moderate–High: ~$25 – $996)
- V5200 – $25.18
- V5010 – $45.32
- V5050 / V5060 – $229.61
- V5130 / V5140 – $459.22
- V5211–V5221 – $621.36
- V5260 – $996.09
HCPCS Codes – Hearing Devices & Implant Supplies (L Codes | Very High Cost: ~$22 – $16,579)
- L8614 – $16,579.85
- L8619 – $6,743.24
- L8627 – $6,216.03
- L8628 – $1,087.91
- L8618 – $22.99
These are some common CPT and HCPCS codes used for hearing aid billing under Florida Medicaid. Refer to the full table for a comprehensive list of hearing services codes.
About Florida Medicaid Hearing Services
Florida’s Medicaid Audiology billing process uses an audit-structured fee schedule that determines reimbursement levels based on CPT (procedure) code, Service Type, and Billing Components (Facility, Professional, and Technical). Proper coding is important because of the large differences in reimbursement rates per test/device, driven by the complexity of the test(s)/device(s).
Reimbursement approval for certain services, particularly high-cost hearing implants and advanced diagnostic testing, may require Prior Authorization.
Medicaid Audiology billing is categorized as follows:
- CPT Codes (Procedure Code) are utilized for audiology evaluations, audiology diagnostic testing, and clinical hearing assessment.
- HCPCS Codes (Healthcare Common Procedure Coding System) are utilized for hearing aids, cochlear implants, durable medical equipment, and supplies.
Important Information:
- Codes that are designated “Y” need pre-authorization before payment is made.
- Device codes have very strict approval requirements.
- Facility payments are different from those for non-facility payments.
Florida Hearing Services CPT Codes and Rates
➜ CPT Codes (69210–92588)
| Code | Modifiers | FS | Facility | Professional Component (PC) | Technical Component (TC) | Prior Authorization (PA) |
| 69210 | — | $35.72 | $21.21 | — | — | — |
| 92537 | — | $29.47 | — | $22.73 | $6.74 | — |
| 92538 | — | $16.24 | — | $11.49 | $4.75 | — |
| 92541 | — | $18.48 | — | $15.23 | $3.25 | — |
| 92542 | — | $21.23 | — | $18.23 | $3.00 | — |
| 92544 | — | $13.24 | — | $10.49 | $2.75 | — |
| 92545 | — | $12.49 | — | $9.74 | $2.75 | — |
| 92546 | — | $91.88 | — | $10.03 | $81.85 | — |
| 92547 | — | $5.86 | — | — | — | — |
| 92550 | — | $16.24 | — | — | — | — |
| 92552 | — | $25.97 | — | — | — | — |
| 92553 | — | $31.50 | — | — | — | — |
| 92555 | — | $19.54 | — | — | — | — |
| 92556 | — | $28.11 | — | — | — | — |
| 92557 | — | $26.73 | $20.99 | — | — | — |
| 92558 | — | $7.24 | $5.52 | — | — | — |
| 92567 | — | $9.58 | $7.07 | — | — | — |
| 92568 | — | $11.49 | $9.94 | — | — | — |
| 92570 | — | $23.48 | $19.00 | — | — | — |
| 92571 | — | $15.44 | — | — | — | — |
| 92572 | — | $19.82 | — | — | — | — |
| 92579 | — | $32.22 | $24.31 | — | — | — |
| 92582 | — | $60.00 | — | — | — | — |
| 92587 | — | $16.49 | — | $13.74 | $2.75 | — |
| 92588 | — | $25.23 | — | $21.48 | $3.75 | — |
➜ CPT CODES (92601–92700)
| Code | Modifiers | FS | Facility | Professional Component (PC) | Technical Component (TC) | Prior Authorization (PA) |
| 92601 | — | $115.40 | $80.43 | — | — | — |
| 92602 | — | $72.69 | $45.52 | — | — | — |
| 92603 | — | $108.90 | $78.21 | — | — | — |
| 92604 | — | $65.44 | $43.53 | — | — | — |
| 92620 | — | $66.19 | $52.36 | — | — | — |
| 92621 | — | $15.74 | $12.38 | — | — | — |
| 92622 | — | $71.81 | — | — | — | — |
| 92623 | — | $53.69 | — | — | — | — |
| 92626 | — | $62.94 | $44.71 | — | — | — |
| 92627 | — | $14.99 | $11.49 | — | — | — |
| 92630 | — | $63.34 | $54.50 | — | — | — |
| 92633 | — | $14.98 | $12.77 | — | — | — |
| 92640 | — | $76.28 | — | — | — | — |
| 92650 | — | $62.42 | — | — | — | — |
| 92651 | — | — | $45.47 | $47.62 | — | — |
| 92652 | — | 54.35 | — | — | — | — |
| 92653 | — | 63.38 | — | — | — | — |
| 92700 | — | — | — | — | — | — |
Florida Hearing Services HCPCS Codes and Rates
➜ HCPCS L CODES
| Code | Modifiers | FS | Facility | Professional Component (PC) | Technical Component (TC) | Prior Authorization (PA) |
| L7510 | — | — | — | — | — | Y |
| L8614 | — | $16579.85 | — | — | — | Y |
| L8615 | — | $358.80 | — | — | — | Y |
| L8616 | — | $84.22 | — | — | — | Y |
| L8617 | — | $74.21 | — | — | — | Y |
| L8618 | — | $22.99 | — | — | — | Y |
| L8619 | — | $6743.24 | — | — | — | Y |
| L8623 | — | $53.23 | — | — | — | Y |
| L8624 | — | $132.45 | — | — | — | Y |
| L8627 | — | $6216.03 | — | — | — | Y |
| L8628 | — | $1087.91 | — | — | — | Y |
| L8629 | — | $122.33 | — | — | — | Y |
| L8691 | — | $2187.36 | — | — | — | Y |
| L8692 | — | $2757.93 | — | — | — | Y |
| L8694 | — | $566.76 | — | — | — | Y |
➜ HCPCS V Codes
| Code | Modifiers | FS | Facility | Professional Component (PC) | Technical Component (TC) | Prior Authorization (PA) |
| V5010 | — | $45.32 | — | — | — | — |
| V5014 | — | $114.81 | — | — | — | — |
| V5014 | TS | $15.11 | — | — | — | — |
| V5050 | — | $229.61 | — | — | — | — |
| V5060 | — | $229.61 | — | — | — | — |
| V5090 | — | $115.81 | — | — | — | — |
| V5130 | — | $459.22 | — | — | — | — |
| V5140 | — | $459.22 | — | — | — | — |
| V5160 | — | $231.62 | — | — | — | — |
| V5171 | — | $229.61 | — | — | — | — |
| V5172 | — | $229.61 | — | — | — | — |
| V5181 | — | $229.61 | — | — | — | — |
| V5200 | — | $25.18 | — | — | — | — |
| V5211 | — | $621.36 | — | — | — | — |
| V5212 | — | $621.36 | — | — | — | — |
| V5213 | — | $621.36 | — | — | — | — |
| V5214 | — | $621.36 | — | — | — | — |
| V5215 | — | $621.36 | — | — | — | — |
| V5221 | — | $621.36 | — | — | — | — |
| V5240 | — | $50.35 | — | — | — | — |
| V5256 | — | $570.88 | — | — | — | — |
| V5257 | — | $559.67 | — | — | — | — |
| V5260 | — | $996.09 | — | — | — | — |
| V5261 | — | $980.74 | — | — | — | — |
| V5264 | — | $18.13 | — | — | — | — |
| V5299 | — | — | — | — | — | Y |
Important 2026 Update: Starting January 1, 2026, a new set of CPT codes (92628–92642) replaces the older hearing aid fitting codes 92590–92595. These new codes cover evaluations, device selection, fitting, and verification. Not all insurers adopt them right away, so verify whether Florida Medicaid or a managed-care plan still uses the older codes or requires the new ones.
Let’s now go through the details of each code and its fee schedule:
CPT Codes (69210–92588) for Diagnostic & Evaluation Audiology Services
The following CPT codes are considered audiology CPT codes for Florida Medicaid and will be broken down according to how they are covered through the reimbursement process:
- Some of these codes contain a split between Facility Service (FS) vs. a facility charge (facility).
- Some contain a split of the service into two parts, i.e., the technical component (TC) and professional component (PC).
- Some are paid as a single amount (globally), and other factors that determine each code’s reimbursement process.
| Code | Modifiers | FS | Facility | Professional Component (PC) | Technical Component (TC) | Prior Authorization (PA) |
| 69210 | — | $35.72 | $21.21 | — | — | — |
| 92537 | — | $29.47 | — | $22.73 | $6.74 | — |
| 92538 | — | $16.24 | — | $11.49 | $4.75 | — |
| 92541 | — | $18.48 | — | $15.23 | $3.25 | — |
| 92542 | — | $21.23 | — | $18.23 | $3.00 | — |
| 92544 | — | $13.24 | — | $10.49 | $2.75 | — |
| 92545 | — | $12.49 | — | $9.74 | $2.75 | — |
| 92546 | — | $91.88 | — | $10.03 | $81.85 | — |
| 92547 | — | $5.86 | — | — | — | — |
| 92550 | — | $16.24 | — | — | — | — |
| 92552 | — | $25.97 | — | — | — | — |
| 92553 | — | $31.50 | — | — | — | — |
| 92555 | — | $19.54 | — | — | — | — |
| 92556 | — | $28.11 | — | — | — | — |
| 92557 | — | $26.73 | $20.99 | — | — | — |
| 92558 | — | $7.24 | $5.52 | — | — | — |
| 92567 | — | $9.58 | $7.07 | — | — | — |
| 92568 | — | $11.49 | $9.94 | — | — | — |
| 92570 | — | $23.48 | $19.00 | — | — | — |
| 92571 | — | $15.44 | — | — | — | — |
| 92572 | — | $19.82 | — | — | — | — |
| 92579 | — | $32.22 | $24.31 | — | — | — |
| 92582 | — | $60.00 | — | — | — | — |
| 92587 | — | $16.49 | — | $13.74 | $2.75 | — |
| 92588 | — | $25.23 | — | $21.48 | $3.75 | — |
CPT Code 69210
This code will be reimbursed at $35.72 (FS) and $21.21 (Facility), as outlined in the 2026 Florida Medicaid hearing services fee schedule. Due to an adjustment made at the site-of-service level, a lower rate will be applied to all facility charges for hearing tests in Florida Medicaid. There will be no separation of the technical component (TC) and professional component (PC). Therefore, there will be no reimbursement for separate components.
CPT Code 92537
CPT Code 92537 is reimbursed at $29.47 (FS) and will be separated into the following components: professional component (PC)=$22.73, technical component (TC)= $6.74. As per Florida Medicaid audiology billing guidelines, the reimbursement model for this code is a component-based payment system, in which the provider submits both their professional fees for the work performed and the technical fees associated with providing those services.
CPT Code 92538
It has been reimbursed at $16.24 (FS) and will be separated into the following components: professional component (PC) = $11.49, technical component (TC)= $4.75. This represents a lower reimbursement tier in Florida Medicaid hearing services CPT codes and rates. However, this code follows the same component-based payment model as 92537 above.
CPT Code 92541
This code is reimbursed at $18.48 (FS) and has been separated into the following components: professional component (PC) = $15.23, technical component (TC) = $3.25. More money is being allocated to the professional component, which is important when determining the percentage of the reimbursement that goes toward provider-only services in Florida hearing services reimbursement.
CPT Code 92542
It has been reimbursed at $21.23 (FS) and will be separated into the following components: professional component (PC) = $18.23, technical component (TC) = $3.00. Again, more money is being allocated to the professional component, following the same pattern discussed previously.
CPT Code 92544
It is reimbursed at $13.24 (FS) and has been separated into the following components: professional component (PC) = $10.49, technical component (TC) = $2.75. This code has a lower reimbursement amount, but there is no public evidence that Florida Medicaid plans to reduce it further. Always rely on the official fee schedule for current rates.
CPT Code 92545
It has been reimbursed at $12.49 (FS) and separated into the following components:
- professional component (PC) = $9.74
- technical component (TC) = $2.75
Like 92544 above, this is another example of a low-value reimbursement code that follows similar patterns in component billing under Florida Medicaid audiology billing guidelines.
CPT Code 92546
It has a total reimbursement of $91.88 (FS), split between $10.03 (PC) and $81.85 (TC). It should be noted that the TC receives the largest portion of the total reimbursement. Thus, when billing in a facility vs. a non-facility setting, reimbursement will often relate more to the equipment/resource used than the time utilized by the provider. Therefore, it is important to determine how your patient’s hearing test reimbursement is affected, depending on whether they were billed in a facility or non-facility setting.
CPT Code 92547
It has been reimbursed at $5.86 (FS), with no PC/TC split breakdown. This is one of the lower reimbursed codes and can either be billed as a stand-alone service or added on to other services under Florida Medicaid audiology billing guidelines.
CPT Code 92550
This code is reimbursed at $16.24 (FS) with no facility or PC/TC split. This represents a globally reimbursed service under hearing services reimbursement in Florida.
CPT Code 92552
This code is reimbursed at $25.97 (FS), with no facility or PC/TC split. This represents consistent reimbursement across all locations listed in the 2026 Florida Medicaid hearing services fee schedule.
CPT Code 92553
It has been reimbursed at $31.50 (FS), with no PC/TC split. This is a moderate value reimbursement code under Florida hearing services CPT codes and rates.
CPT Code 92555
It has been reimbursed at $19.54 (FS). With no PC/TC split applied to this code, it follows a flat rate model for all types of hearing services reimbursement in Florida.
CPT Code 92556
This code is reimbursed at $28.11 (FS), with no facility or PC/TC split applied. This represents a standardized method of hearing services reimbursement in Florida.
CPT Code 92557
This code is reimbursed at $26.73 (FS), with a facility rate of $20.99. This is an example of a significant decrease in reimbursement due to site-of-service adjustments made to reduce overhead costs to facilities in the Florida Medicaid audiology fee schedule 2026.
CPT Code 92558
This code is reimbursed at $7.24 (FS), with a facility rate of $5.52. The reimbursement for 92558 is currently on the lower side. Since rates can change, always check the official Florida Medicaid fee schedule to see the exact amount.
CPT Code 92567
It has been reimbursed at $9.58 (FS), with a facility rate of $7.07. This follows the same facility-adjusted reimbursement methodology found throughout all other hearing services CPT codes and rates under Florida Medicaid audiology billing guidelines.
CPT Code 92568
It has been reimbursed at $11.49 (FS), with a facility rate of $9.94. Although the difference between FS and facility rate is reduced, this indicates some degree of site-of-service impact on hearing services reimbursement under Florida Medicaid audiology billing guidelines.
CPT Code 92570
It has been reimbursed at $23.48 (FS), with a facility rate of $19.00. This represents a middle tier of values for hearing services reimbursement in Florida.
CPT Code 92571
This code is reimbursed at $15.44 (FS), with no facility or PC/TC split applied to this code. This represents a flat rate of reimbursement under the 2026 Florida Medicaid hearing services fee schedule.
CPT Code 92572
It has been reimbursed at $19.82 (FS). With no PC/TC split applied to this code, this indicates that this code will be reimbursed regardless of location.
CPT Code 92579
This code is reimbursed at $32.22 (FS), with a facility rate of $24.31. This represents an increased value for an audiology CPT code under Florida Medicaid hearing test reimbursement.
CPT Code 92582
It has been reimbursed at $60.00 (FS), with no facility rate provided for this code. Based on past trends in flat-rate CPT code payments in the Florida Medicaid audiology fee schedule 2026, this appears to be one of the highest flat rates.
CPT Code 92587
It has been reimbursed at $16.49 (FS), with a split of $13.74 (PC) and $2.75 (TC). This code represents a component-based payment model, with the majority of funds allocated towards the professional component.
CPT Code 92588
This code has been reimbursed at $25.23 (FS), with a split of $21.48 (PC) and $3.75 (TC). Similar to 92587 above, this code also represents a PC-heavy payment structure and follows the same guidelines established under Florida Medicaid audiology billing guidelines.
CPT Codes (92601–92700) for Advanced Audiology & Cochlear Implant Services
| Code | Modifiers | FS | Facility | Professional Component (PC) | Technical Component (TC) | Prior Authorization (PA) |
| 92601 | — | $115.40 | $80.43 | — | — | — |
| 92602 | — | $72.69 | $45.52 | — | — | — |
| 92603 | — | $108.90 | $78.21 | — | — | — |
| 92604 | — | $65.44 | $43.53 | — | — | — |
| 92620 | — | $66.19 | $52.36 | — | — | — |
| 92621 | — | $15.74 | $12.38 | — | — | — |
| 92622 | — | $71.81 | — | — | — | — |
| 92623 | — | $53.69 | — | — | — | — |
| 92626 | — | $62.94 | $44.71 | — | — | — |
| 92627 | — | $14.99 | $11.49 | — | — | — |
| 92630 | — | $63.34 | $54.50 | — | — | — |
| 92633 | — | $14.98 | $12.77 | — | — | — |
| 92640 | — | $76.28 | — | — | — | — |
| 92650 | — | $62.42 | — | — | — | — |
| 92651 | — | — | $45.47 | $47.62 | — | — |
| 92652 | — | $54.35 | — | — | — | — |
| 92653 | — | $63.38 | — | — | — | — |
| 92700 | — | — | — | — | — | Y |
The CPT codes 92601 through 92700 comprise audiology CPT codes, Florida Medicaid, and adhere to the Site-of-Services-based reimbursement rules. These rules mean that the payment for these services can vary depending on whether they are performed in an FS (non-facility) or a facility setting.
CPT Code 92601
Florida’s Medicaid will reimburse this code for $115.40 when billed as an FS under their 2026 Hearing Services Fee Schedule. However, Florida’s Medicaid will pay $80.43 when the facility provides the service. The reason for this variation is related to how Florida Medicaid structures its hearing services reimbursement.
CPT Code 92602
When this code is used, Florida’s Medicaid will pay $72.69 (FS) and $45.52 (facility). As noted previously, the facility rate is lower than the FS rate. Again, this is consistent with Florida Medicaid’s reimbursement policies regarding hearing tests. Facilities absorb some technical overhead in addition to the cost of performing the actual hearing test.
CPT Code 92603
Florida Medicaid will reimburse this code for $108.90 (FS) and $78.21 (facility). While both rates are high relative to others, there is still a significant reduction in reimbursement when a provider performs this service in a facility versus an FS. The reimbursement rates for Florida Medicaid hearing services are adjusted downward depending on whether the service is provided in a facility.
CPT Code 92604
Florida Medicaid will pay $65.44 (FS) and $43.53 (facility). There is a large difference in reimbursement when the service is provided in an FS versus a facility. When a provider works in a facility, many technical and administrative tasks are handled by facility personnel.
CPT Code 92620
Florida Medicaid will reimburse this code for $66.19 (FS) and $52.36 (facility). As with prior examples, the reimbursement varies significantly based on where the service is delivered. However, there is much less variation between FS and facility rates than in many other codes.
CPT Code 92621
Florida Medicaid will pay $15.74 (FS) and $12.38 (facility). This code has a lower reimbursement rate than others.
CPT Code 92622
Florida Medicaid will reimburse this code for $71.81 (FS) regardless of whether the service was provided in an FS or Facility setting. While Florida Medicaid does provide reimbursement for services provided in facilities, there are instances in which they choose to use flat-rate pricing rather than different reimbursement rates for different locations.
CPT Code 92623
Florida Medicaid will pay $53.69 (FS) for this code, regardless of whether the service was provided in an FS or a Facility setting. Based on past practices under Florida Medicaid Audiology Billing Guidelines, it appears that Florida’s Medicaid program has established a flat rate for this service. Therefore, providers should expect to receive the same amount of reimbursement regardless of whether they see patients in their own offices or in a facility setting.
CPT Code 92626
Florida’s Medicaid will reimburse this code for $62.94 (FS) and $44.71 (facility). Although there is still a significant reduction in reimbursement between FS and Facility settings, the differential between the two reimbursement rates is smaller than most codes listed here.
CPT Code 92627
Florida’s Medicaid will pay $14.99 (FS) and $11.49 (facility) for this code. Consistent with prior discussions on low reimbursement rates, they generally indicate that either the service is short or considered an “add-on” type of service. This is consistent with prior examples demonstrating that low reimbursement rates often relate to shorter or add-on services.
CPT Code 92630
Florida Medicaid will reimburse this code for $63.34 (FS) and $54.50 (facility). The relatively small differential between FS and Facility rates demonstrates a more even-handed approach to reimbursement than found in many other codes listed here.
CPT Code 92633
Florida Medicaid will pay $14.98 (FS) and $12.77 (facility) for this code.
CPT Code 92640
Florida Medicaid will pay $76.28 (FS) for this code regardless of where it was provided. Therefore, providers should expect to receive the same reimbursement amount whether they deliver this service in an FS or a Facility setting.
CPT Code 92650
Florida’s Medicaid will pay $62.42 (FS) regardless of whether the service was delivered in an FS or a facility setting. Providers delivering this service can expect to receive the same reimbursement amount regardless of whether they deliver it in their own offices or in a facility setting.
CPT Code 92651
Florida Medicaid pays $45.47 (FS) and $47.62 (Facility) for CPT code 92651. In this case, the facility rate is higher than the FS rate, which is uncommon. This likely reflects the greater use of equipment and technical support in facility settings.
CPT Code 92652
Florida Medicaid will pay $54.35 (FS) regardless of delivery location; i.e., whether it was an FS or a Facility delivery. This code reflects a uniform reimbursement policy established by Florida Medicaid through its Audiology Billing Guidelines.
CPT Code 92653
Florida Medicaid will pay $63.38 (FS) for this code, regardless of whether it was delivered in an FS or a Facility setting. This also reflects a uniform approach to reimbursement.
CPT Code 92700
No specific reimbursement has been identified for this code by Florida Medicaid. A manual determination must be made regarding reimbursement, although Prior Approval (Y-Pa) is required before proceeding with treatment. As an unlisted service under Florida Medicaid Audiology Billing Guidelines, reimbursement amounts depend on documentation submitted during the approval process and cannot be predetermined, like many other codes listed here.
Prosthetic Hearing Devices & Implantable Audiology Equipment HCPCS L CODES
| Code | Modifiers | FS | Facility | Professional Component (PC) | Technical Component (TC) | Prior Authorization (PA) |
| L7510 | — | — | — | — | — | Y |
| L8614 | — | $16579.85 | — | — | — | Y |
| L8615 | — | $358.80 | — | — | — | Y |
| L8616 | — | $84.22 | — | — | — | Y |
| L8617 | — | $74.21 | — | — | — | Y |
| L8618 | — | $22.99 | — | — | — | Y |
| L8619 | — | $6743.24 | — | — | — | Y |
| L8623 | — | $53.23 | — | — | — | Y |
| L8624 | — | $132.45 | — | — | — | Y |
| L8627 | — | $6216.03 | — | — | — | Y |
| L8628 | — | $1087.91 | — | — | — | Y |
| L8629 | — | $122.33 | — | — | — | Y |
| L8691 | — | $2187.36 | — | — | — | Y |
| L8692 | — | $2757.93 | — | — | — | Y |
| L8694 | — | $566.76 | — | — | — | Y |
Some L‑codes, especially those for cochlear or auditory‑brainstem implants, may need prior authorization depending on the insurer. Not every L‑code automatically requires approval; always confirm with Florida Medicaid or the managed‑care plan.
HCPCS Code – L7510
L7510 does not have a predetermined reimbursement value according to the Florida Medicaid hearing services fee schedule 2026. Instead, Reimbursement values are calculated on a case-by-case basis following successful completion of Prior Authorization.
For cochlear implant components like L8614 and L8619, you may need to submit proof that the device is medically necessary and get prior authorization. Other L‑codes might not need prior approval, but you should always check the patient’s plan for requirements.
HCPCS Code – L8614
According to the Florida Medicaid hearing services fee schedule 2026, L-8614 is reimbursed at an extremely high amount of $16,579.85 (FS). Because the amount reimbursed for this code is so high, Prior Authorization is strictly enforced, and all claims submitted under this code must meet the stringent criteria outlined in Florida Medicaid’s audiology billing guidelines to avoid denial or delayed payment.
HCPCS Code – L8615
L8615 is reimbursed at an intermediate amount of $358.80 (FS) under the 2026 hearing services fee schedule offered by Florida Medicaid. Intermediate codes are those codes that do not fall into either bottom-tier or top-tier codes but rather fall somewhere in between. These codes may require prior authorization depending on the payer; verify with Florida Medicaid or the member’s plan.
HCPCS Code – L8616
L8616 is reimbursed at a relatively low amount of $84.22 (FS) under the 2026 hearing services fee schedule offered by Florida Medicaid. Low-payers are those codes that pay at a lower rate than most other codes included in the hearing services fee schedule 2026.
HCPCS Code – L8617
L8617 is reimbursed at $74.21 (FS) as part of the 2026 hearing services fee schedule offered by Florida Medicaid. Low-payers are those codes that pay at a lower rate than most other codes included in the hearing services fee schedule 2026.
HCPCS Code – L8618
L8618 is reimbursed at an extremely low amount of $22.99 (FS) under the 2026 hearing services fee schedule offered by Florida Medicaid. Extremely low-payers are codes that pay at a rate even lower than the low-payers included in the hearing services fee schedule 2026.
HCPCS Code – L8619
L8619 is reimbursed at an extremely high amount of $6,743.24 (FS) under the 2026 hearing services fee schedule offered by Florida Medicaid. High-payers are those codes that pay at an extremely high rate compared to most other codes included in the hearing services fee schedule 2026.
HCPCS Code – L8623
L8623 is reimbursed at a low/moderate amount of $53.23 (FS) under the 2026 hearing services fee schedule offered by Florida Medicaid. Moderate-payers are those codes that pay at an average rate compared to most other codes included in the hearing services fee schedule 2026.
HCPCS Code – L8624
L8624 is reimbursed at a moderate amount of $132.45 (FS) under the 2026 hearing services fee schedule offered by Florida Medicaid.
HCPCS Code – L8627
L8627 is reimbursed at an extremely high amount of $6,216.03 (FS) under the 2026 hearing services fee schedule offered by Florida Medicaid.
HCPCS Code – L8628
L8628 is reimbursed at an upper-midrange amount of $1,087.91 (FS) as part of the 2026 hearing services fee schedule offered by Florida Medicaid. Upper-mid-range codes are those that pay at an above-average rate compared to most other codes in the hearing services fee schedule 2026.
HCPCS Code – L8629
L8629 is reimbursed at a moderate amount of $122.33 (FS) under the 2026 hearing services fee schedule offered by Florida Medicaid.
HCPCS Code – L8691
L8691 is reimbursed at an extremely high amount of $2,187.36 (FS) under the 2026 hearing services fee schedule offered by Florida Medicaid.
HCPCS Code – L8692
This code reimbursed at $2,757.93 (Florida Schedule) is in line with other “high value” codes. All prior authorization and documentation requirements for Hearing Services Reimbursement in Florida apply to these “high value” codes.
HCPCS Code – L8694
L8694 reimbursement amount is $566.76 (Florida Schedule), which would be considered a mid-to-high reimbursement level among all the hearing services CPT Codes and Rates available through Florida. These codes may require prior authorization depending on the payer; verify with Florida Medicaid or the member’s plan.
HCPCS V Codes for Hearing Aids & Assistive Listening Devices
| Code | Modifiers | FS | Facility | Professional Component (PC) | Technical Component (TC) | Prior Authorization (PA) |
| V5010 | — | $45.32 | — | — | — | — |
| V5014 | — | $114.81 | — | — | — | — |
| V5014 | TS | $15.11 | — | — | — | — |
| V5050 | — | $229.61 | — | — | — | — |
| V5060 | — | $229.61 | — | — | — | — |
| V5090 | — | $115.81 | — | — | — | — |
| V5130 | — | $459.22 | — | — | — | — |
| V5140 | — | $459.22 | — | — | — | — |
| V5160 | — | $231.62 | — | — | — | — |
| V5171 | — | $229.61 | — | — | — | — |
| V5172 | — | $229.61 | — | — | — | — |
| V5181 | — | $229.61 | — | — | — | — |
| V5200 | — | $25.18 | — | — | — | — |
| V5211 | — | $621.36 | — | — | — | — |
| V5212 | — | $621.36 | — | — | — | — |
| V5213 | — | $621.36 | — | — | — | — |
| V5214 | — | $621.36 | — | — | — | — |
| V5215 | — | $621.36 | — | — | — | — |
| V5221 | — | $621.36 | — | — | — | — |
| V5240 | — | $50.35 | — | — | — | — |
| V5256 | — | $570.88 | — | — | — | — |
| V5257 | — | $559.67 | — | — | — | — |
| V5260 | — | $996.09 | — | — | — | — |
| V5261 | — | $980.74 | — | — | — | — |
| V5264 | — | $18.13 | — | — | — | — |
| V5299 | — | — | — | — | — | Y |
HCPCS Code- V5010
V5010 is paid by Florida Medicaid at a fixed amount of $45.32 (FS). The facility portion of the bill is bundled with the professional portion. Therefore, there is no facility charge. Many HCPCS V codes use flat-rate reimbursement, whereas CPT codes vary by setting and component.
HCPCS Code-V5014
The 2026 fee schedule for Florida Medicaid has set the Reimbursement for V5014 at $114.81 (FS). This payment is made separately from the professional component (pc)/technical component (tc) and can be used toward your billing for device-related services.
HCPCS Code-V5014 (TS modifier)
For V5014 with the TS modifier, Florida Medicaid pays $15.11 (FS). The TS modifier is used for follow-up services, and the payment is set as a fixed rate rather than an increased amount.
HCPCS Code-V5050
As part of the Hearing Aid billing codes, Florida Medicaid, V5050, is paid at a fixed price of $229.61 (FS). No facilities charges are added to this code.
HCPCS Code-V5060
Similar to V5050, V5060 is also priced at $229.61 (FS). The two codes show that Florida Medicaid has created parity for coding purposes.
HCPCS Code-V5090
For some types of service-related billing codes, such as V5090, Florida Medicaid uses a bundling model for payment. In these cases, instead of paying a separate technical charge (tc), the technical and professional fees are combined into one payment. For example, V5090 pays at a rate of $115.81 (FS).
HCPCS Code-V5130
For the more advanced device-related billing codes, such as V5130, Florida Medicaid pays a significantly higher amount than for basic codes. For example, V5130 is paid at $459.22 (FS).
HCPCS Code-V5140
Like V5130, V5140 is also paid at $459.22 (FS). Like other devices billed in the same way, Florida Medicaid has maintained parity in its fee structure for similar devices.
HCPCS Code-V5160
The mid-range Reimbursement codes, including V5160, are reimbursed by Florida Medicaid at $231.62 (FS).
HCPCS Codes-V5171/V5172/V5181
In addition to creating a structured fee schedule for different levels of service and devices, Florida Medicaid has created parity between similar service codes. As examples, V5171, V5172, and V5181 each pay $229.61 (FS).
HCPCS Code-V5200
Codes such as V5200 are reimbursed at a slightly higher rate of $25.18 (FS) than most device-related billing codes because they include fitting-related costs in addition to the device cost.
HCPCS Codes-V5211-V5215
The code labeled with V5211-V5215 pays a very high rate of $621.36 (FS) and demonstrates Florida Medicaid’s commitment to providing higher reimbursements to support patients who need more expensive technology.
HCPCS Code-V5221
Like V5211-V5215, V5221 also pays a higher Reimbursement rate of $621.36 (FS).
HCPCS Code-V5240
Florida Medicaid uses lower-cost reimbursable items to determine how much to pay for lower-revenue billing codes, such as V5240. For example, V5240 is paid at $50.35 (FS).
HCPCS Code-V5256
The reimbursement code V5256 is paid at $570.88 (FS).
HCPCS Code-V5257
A few codes are paid slightly lower than highly paid reimbursement codes. Examples include V5257, which pays $559.67 (FS), and, while lower than highly paid code like V5211-V5215, V5221 paid at $621.36 (FS).
HCPCS Code-V5260
One of the highest payment codes is V5260, which pays $996.09 (FS), indicating a highly paid under Florida Medicaid’s hearing services fee schedule 2026.
HCPCS Code-V5261
High-end Reimbursement codes are those that pay at a high level. Therefore, V5261 is a high-end code that pays $980.74 (FS).
HCPCS Code-V5264
Some codes pay minimal amounts for small parts or pieces of equipment under Florida Medicaid’s audiology billing guidelines. An example includes V5264, which pays $18.13 (FS).
HCPCS Code-V5299
Although Florida Medicaid’s audiology fee schedule 2026 has established specific reimbursement rates for each audiology-related billing code, the organization reserves the right to manually review each individual claim for payment eligibility, and Prior Authorization (PA: Y) must always be obtained prior to submission for reimbursement.
FAQs
Does Florida Medicaid cover hearing services?
Yes, Florida Medicaid provides a variety of hearing and audiology services, including diagnostic hearing evaluations and hearing aid services. If services are considered medically necessary and completed by an enrolled provider in compliance with Florida Medicaid’s guidelines, then coverage would apply.
What is CPT 92557 reimbursement in Florida?
The average reimbursement amounts for CPT 92557 can vary based upon whether the service was rendered in a facility or non-facility setting, e.g.:
- FS rate: Approximately $26.73
- Facility Rate: Approximately $20.99
Based on changes to Medicaid updates, provider agreements, and physical adjustments, the reimbursement amount may fluctuate.
How much does Florida Medicaid pay for hearing tests?
The payment amount for Florida Medicaid varies by CPT code and place of service. The majority of routine hearing tests fall within the $5 to $60+ price range. For example, non-facility CPT 92557 is paid at approximately $26.73, while facility CPT 92557 is paid at $20.99. This information can be found on the state’s official Medicaid fee schedule. However, rates may also depend upon service type and/or your provider’s location.
Which audiology CPT codes are covered under Florida Medicaid?
Florida Medicaid covers all types of audiology CPT codes. These include:
Routine hearing tests:
- CPT code 92552
- CPT code 92553
- CPT code 92555
- CPT code 92556
- CPT code 92557
Tests related to middle ear function:
- CPT code 92567
- CPT code 92568
Balance/vestibular testing:
- CPT code 92537
- CPT code 92541
- CPT code 92542
- CPT code 92545
- CPT code 92546
Advanced audiology services:
- CPT codes 92601-92604
- CPT code 92620
- CPT code 92621
All of these codes will be used to evaluate hearing or diagnose balance issues, as well as to provide additional medical treatment that is medically necessary.
