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See a sample rate comparisonHCPCS V5258 Fee Schedule
Last Verified: September 2026
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
Hearing aid, digital, binaural, CIC
| Key Fact | Detail |
|---|---|
| Service Type | Hearing Services Hearing Aids |
| Complexity Level | High |
| Medicaid Fee Schedule | View Medicaid rates for V5258 |
National average reimbursement for HCPCS V5258 by major payers:
$2,720.07
$5,023.32
$1,714.62
$2,195.23
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HCPCS V5258
5 of 25 sample ratesHigher to lower in this preview
Hospital Authority Of Jefferson County And The City Of Louisville, Jefferson Hospital
Hospital Authority Of Jefferson County And The City Of Louisville
$5,151.50Published rateChu Chen
$5,000.00Published rateHospital Authority Of Washington County, Washington County Regional Medical Center
$5,000.00Published rateEmanuel County Hospital Authority, Emanuel Medical Center
$5,000.00Published rateVictoria Lewis-Holland
$5,000.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS V5258 vs. Other Hearing Aids Codes
The HCPCS V5258 code is part of the Hearing Services services used for Hearing Aids. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The HCPCS V5258 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| V5257-HCPCS | High | Hearing aid, digital, monaural, BTE |
| V5258-HCPCS | High | Hearing aid, digital, binaural, CIC |
| V5259-HCPCS | High | Hearing aid, digital, binaural, ITC |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS V5258. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the V5258 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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