V5264 HCPCS code: Ear mold/insert, not disposable, any type
V5264 is the HCPCS Level II code for ear mold/insert, not disposable, any type. Its Medicare coverage code is S (Non-covered by Medicare statute): Medicare is barred by law from covering it.
Code details
| Field | Value |
|---|---|
| Section | V codes — Vision, hearing and speech-language pathology services |
| Coverage code | S — Non-covered by Medicare statute |
| Pricing indicator | 00 — Not separately priced by Medicare |
| BETOS category | O1F — Hearing and speech services |
| Added | 2002-01-01 |
| Last action effective | 2002-01-01 |
What changed for V5264
- 2002-01-01: V5264 added to HCPCS Level II
- Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01
Frequently asked questions
What is HCPCS code V5264?
V5264 is the HCPCS Level II code for ear mold/insert, not disposable, any type. Short descriptor: "Ear mold/insert".
Does Medicare cover V5264?
Coverage code S — Non-covered by Medicare statute. Medicare is barred by law from covering it.
Related V52 codes
- V5200 — Dispensing fee, contralateral, monaural
- V5210 — Hearing aid, bicros, in the ear
- V5211 — Hearing aid, contralateral routing system, binaural, ite/ite
- V5212 — Hearing aid, contralateral routing system, binaural, ite/itc
- V5213 — Hearing aid, contralateral routing system, binaural, ite/bte
- V5214 — Hearing aid, contralateral routing system, binaural, itc/itc
- V5215 — Hearing aid, contralateral routing system, binaural, itc/bte
- V5220 — Hearing aid, bicros, behind the ear
- V5221 — Hearing aid, contralateral routing system, binaural, bte/bte
- V5230 — Hearing aid, contralateral routing system, binaural, glasses
- V5240 — Dispensing fee, contralateral routing system, binaural
- V5241 — Dispensing fee, monaural hearing aid, any type
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Next steps
- Run a reimbursement report for a device billed under V5264
- Watch V5264 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for V5264
Sources: CMS HCPCS Level II release October 2025; CMS DMEPOS fee schedule; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.