2026 CPT® Code Updates (Yes, They Apply to Dispensers!) - IHS Member Exclusive-CPT Codes Video

Video Transcription

Video Summary

Samantha Sikorsky, a compliance officer and hearing aid specialist, explains new CPT/HCPCS billing and coding rules for hearing care services. She stresses that providers must know their own scope of practice and only bill services they are legally allowed to perform. She clarifies that many services commonly thought to be “audiology-only” can apply to hearing aid specialists if they fall within scope.<br /><br />The talk focuses on new CPT codes for hearing aid candidacy, selection, fitting, follow-up, verification, hearing aid testing, and ALD fitting. She explains that many of these are time-based codes with midpoint rules, meaning providers must document exact time spent and meet minimum thresholds before billing. She also outlines add-on codes and warns that time spent on verification services like REM or sound-field testing cannot be counted toward the base fitting or follow-up time.<br /><br />Sikorsky gives practical billing scenarios, including when to use or avoid certain codes, how to document properly, and why coding to the highest degree of specificity matters to avoid fraud or overbilling. She closes by noting that these rules are complex and encourages further compliance training and consultation.

Keywords

CPT billing

HCPCS coding

hearing aid services

compliance officer

scope of practice

time-based codes

hearing aid fitting

verification services

billing documentation