V5299: Hearing service, miscellaneous

Medicare coverage: Special coverage instructions apply

There are published conditions attached to this code. Check the applicable coverage policy before billing it: the code being valid is not the same as the service being covered.

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 statusR

Restricted coverage. Special coverage instructions apply, and if covered the service is contractor-priced.

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 V5299 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

1 unit

MAI 3: Date of Service Edit: Clinical · Clinical: CMS Workgroup

outpatient

1 unit

MAI 3: Date of Service Edit: Clinical · Clinical: CMS Workgroup

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.