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SC Medicaid - SCDHHSMedicaid · Billing Codes · Provider Communication · SC · ENT (Ear, Nose & Throat)Medium impact

Audiology Services Policy Updates

Effective date
Jan 1, 2026
Identified
Jun 18, 2026

Summary

South Carolina Medicaid is adding coverage for new audiology CPT codes effective January 1, 2026, including hearing aid selection, fitting, follow-up services, and bone-anchored implant programming. The policy establishes specific billing limitations, frequency restrictions, and reimbursement rates for these services.

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What to do

Action · 3 steps
01Before January 1, 2026: Billing team must add new audiology CPT codes 92631-92641, V5014, 92622, and 92623 to billing system with specific frequency limitations and same-day billing restrictions.
02Update fee schedules with provided reimbursement rates.
03Configure system to enforce 12-month limits and daily restrictions as specified in the policy.
If missed: Failure to properly configure restrictions may result in claim denials.

Codes mentioned

926319263292634926359263692637926389263992641V50149262292623

Original notice

Audiology Services Policy Updates
scdhhs.gov · Always check the source before changing claims.
View original ↗

Related policy hubs

SC Medicaid - SCDHHS policiesSC policy changesENT (Ear, Nose & Throat)Code 92631Code 92632Code 92634Code 92635Code 92636Code 92637Code 92638Code 92639Code 92641Code V5014Code 92622Code 92623

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