CommercialCoverageHigh impact
Automated Audiometry (CPB 0870, reviewed 2025-12-22)
Aetna·Audiology, ENT (Ear, Nose & Throat), Family Medicine +3 more·Medical Policy
Effective date
Dec 22, 2025
We identified it
Aug 12, 2026
Summary
Aetna's updated policy (CPB 0870) clarifies that automated audiometry performed without an audiologist—whether self-administered or administered by non-audiologists—is considered experimental, investigational, or unproven and is NOT COVERED. Billing codes 0208T and 0209T are not covered for these indications. Practices must ensure audiometry services are performed by licensed audiologists to receive reimbursement.
Action Required
Immediately: Billing team must update system edits to DENY claims for CPT codes 0208T and 0209T when billed without audiologist supervision or when documentation indicates self-administration or administration by non-audiologists. Before submitting any claims for automated audiometry, verify that services were performed by a licensed audiologist holding ASHA Certificate of Clinical Competence (CCC). Update internal coding guidelines and provider education materials to clarify that only audiologist-administered automated audiometry is billable. Flag any pending claims for 0208T/0209T for review and possible corrective submission. Failure to comply will result in claim denials and potential overpayment recovery.