V5020: Conformity evaluation
V5020 is a HCPCS Level II code for conformity evaluation. It belongs to the Vision, Hearing and Speech-Language Pathology section. Medicare does not pay it: see the coverage note below before you bill it.
Medicare coverage: Non-covered by statute
Excluded from coverage by the Social Security Act itself, not by a policy decision. No documentation and no appeal changes this one: an ABN is the relevant conversation.
From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q4-Oct. This states Medicare’s position on the code, not on your particular claim.
Physician fee schedule statusN
Non-covered service. Medicare does not cover it.
Global period: XXX
Want the dollar amount for your locality? The fee calculator applies your GPCI and the current conversion factor.
Medically Unlikely Edits: units per day
The most units of V5020 Medicare will pay on one date of service. Bill more on a single line and it is denied. The limit is not the same in every setting, so the row that matters is the one matching the claim you are building.
- practitioner
- 0, never payable MAI 3: Date of Service Edit: Clinical · CMS Policy
- outpatient
- 0, never payable MAI 3: Date of Service Edit: Clinical · CMS Policy
The adjudication indicator decides whether exceeding the limit is worth appealing at all: MAI 1 is a line edit you can support with documentation, MAI 3 is a date-of-service edit that is also appealable, and MAI 2 is absolute, no documentation overrides it. CMS MUE 2026Q4.
The CMS record for V5020
- Long descriptor
- Conformity evaluation
- Short descriptor
- Conformity evaluation
- Added
- January 1, 1984
- BETOS
- O1F
- Pricing indicator
- 00: Not priced by Part B
The official wording. This is what the code means.
CMS's 28-character form, which is what shows up on a remittance advice.
When CMS introduced the code.
Berenson-Eggers Type of Service: CMS's own analytic grouping.
Service not separately priced by Part B, not covered, bundled into another service, or used by Part A only.
Codes adjacent to V5020
HCPCS has no hierarchy: related items simply sit next to each other in the numbering. If V5020 is not quite right, the correct code is very often within a few positions of it.
- V2788Presbyopia correcting function of intraocular lens
- V2790Amniotic membrane for surgical reconstruction, per procedure
- V2797Vision supply, accessory and/or service component of another hcpcs vision code
- V2799Vision item or service, miscellaneous
- V5008Hearing screening
- V5010Assessment for hearing aid
- V5011Fitting/orientation/checking of hearing aid
- V5014Repair/modification of a hearing aid
- V5030Hearing aid, monaural, body worn, air conduction
- V5040Hearing aid, monaural, body worn, bone conduction
- V5050Hearing aid, monaural, in the ear
- V5060Hearing aid, monaural, behind the ear
- V5070Glasses, air conduction
- V5080Glasses, bone conduction
- V5090Dispensing fee, unspecified hearing aid
- V5095Semi-implantable middle ear hearing prosthesis