OasisLMS

Historically, hearing aid specialists have not widely adopted CPT® codes for several reasons. A prevalent misconception was that their scope of practice prevented them from utilizing them. While some recognized this to be inaccurate, there was minimal interest since most codes pertained to audiologic evaluations, with limited applicability to hearing aids. However, this is no longer the case.

Twelve new CPT® codes for hearing aids took effect on January 1, 2026. Nearly a third of the codes are time-based codes, another third are add-ons to those codes. Without fully understanding how time is calculated and the rules for applying the codes, hearing aid specialists could find themselves in violation of more than simple coding ‘mistakes.’

As these codes take effect, health plans must consider their applicability in their benefit offering and determine coverage criteria. It is imperative that hearing aid specialists know about these new codes and consider them during contract negotiations.

Upon completing this course, learners will be able to:
1. Establish protocols that align with time-based codes.
2. Apply new CPT® codes to invoices and claims
3. Defend hearing aid specialists' right to utilize CPT®
4. Define fraud, waste, and abuse

Samantha Sikorski, ACA, CPCO, CDP is a licensed Hearing Instrument Specialist, Audioprosthologist, Certified Dementia Practitioner, Certified Professional Compliance Officer and holds a certificate from the International Hearing Society as a Tinnitus Care Provider. In 2014, after 12 years with two major hearing aid franchises, she founded Sikorski Hearing & Tinnitus Wellness Center. Samantha specializes in practice administration and patient education where she works tirelessly to bridge the gap that often exists in hearing healthcare by working with ENT’s, physicians, neuropsychologists, and other allied healthcare providers. Samantha has authored more than a dozen articles for publication in The Hearing Professional. In 2022, Samantha founded Thistle, LLC, to help other practice owners establish standards of care and policies to comply with the complex regulations that come with owning a healthcare practice.