V5120 Body-worn binaur hearing aid

Binaural, body

Medically Unlikely Edits (effective October 1, 2026)

Medicare pricing for V5120

Physician Fee Schedule (CY 2026, RVU26D)

Status N: non-covered service.

Payer policies and prior authorization for V5120

8 of 8 payer prior-auth lists that name V5120 require prior authorization or set conditions: Blue Cross Blue Shield of Arizona (AZ Blue), Rocky Mountain Health Plans, UnitedHealthcare Community Plan.

PayerPlanStatePrior authConditionsSinceSource
Blue Cross Blue Shield of Arizona (AZ Blue)Federal Employee Program (FEP)AZprior auth under conditionsFEP Standard and Basic onlySep 1, 2026Federal Employee Program (FEP) Prior Authorization Requirements Code List (Updated 09/01/2026)
Rocky Mountain Health PlansRocky Mountain Health Plans CHP+COprior auth requiredOct 1, 2026Rocky Mountain Children’s Health Plan - prior authorization Effective October 1, 2026
UnitedHealthcare Community PlanAHCCCS Complete Care (ACC)AZprior auth under conditionsAge under 21; For members younger than 21: Prior authorization is not required. For members 21 and older: Prior authorization is required.Oct 1, 2026Prior authorization requirements for AHCCCS Complete Care (ACC) Medicaid effective October 1, 2026
UnitedHealthcare Community PlanALTCS Developmentally DisabledAZprior auth under conditionsAge under 21; For members younger than 21: Prior authorization is not required. For members 21 and older: Prior authorization is required.Oct 1, 2026Prior authorization requirements for Arizona Developmental Disabilities Effective October 1, 2026
UnitedHealthcare Community PlanALTCS Long Term CareAZprior auth under conditionsAge under 21; For members younger than 21: Prior authorization is not required. For members 21 and older: Prior authorization is required.Oct 1, 2026Prior authorization requirements for Arizona Long Term Care Effective October 1, 2026
UnitedHealthcare Community PlanMississippi CHIPMSprior auth requiredApr 1, 2025Prior authorization requirements for Mississippi Children’s Health Insurance Program Effective Apr. 1, 2025
UnitedHealthcare Community PlanMississippiCANMSprior auth requiredApr 1, 2025Prior authorization requirements for UnitedHealthcare Community Plan of Mississippi – Mississippi Coordinated Access Network (MississippiCAN) Effective Apr. 1, 2025
UnitedHealthcare Community PlanNew Mexico Turquoise CareNMprior auth requiredOct 1, 2026Prior authorization requirements for UnitedHealthcare Community Plan of New Mexico Effective October 1, 2026

Payer coverage policies that name V5120

V5120 appears in 20 coverage policies from Aetna, Anthem, Blue Cross & Blue Shield of Mississippi, Blue Cross & Blue Shield of Rhode Island, Premera Blue Cross, UnitedHealthcare.

PayerPolicyRole in policyReviewedDocument
AetnaBone-Anchored Hearing Aids (0403)listed, no stance (range V5008-V5299)Jul 22, 2026payer document
AetnaTinnitus Treatments (0406)not covered (range V5010-V5267)Jul 10, 2026payer document
AnthemAir Conduction Hearing Aids (CG-DME-37)covered if criteria are metNov 6, 2025payer document
Blue Cross & Blue Shield of MississippiProsthetics (L.1.04.401)covered if criteria are metpayer document
Blue Cross & Blue Shield of Rhode IslandHearing Aid Coverage
Commercial Products		listed, no stanceJan 1, 2026payer document
Premera Blue CrossHearing Aids (Excludes Implantable Devices)listed, no stanceSep 1, 2026payer document
UnitedHealthcareHearing Aids and Devices Including Wearable, Bone- Anchored, and Semi-Implantable (for Kansas Only) (CS052KS.04)
Wearable Hearing Aids		listed, no stanceSep 1, 2026payer document
UnitedHealthcareHearing Aids and Devices Including Wearable, Bone- Anchored, and Semi-Implantable (for Nebraska Only) (CS052NE.V)
Wearable Hearing Aids		listed, no stanceJun 1, 2026payer document
UnitedHealthcareHearing Aids and Devices Including Wearable, Bone- Anchored, and Semi-Implantable (for New Jersey Only) (CS052NJ.S)
Wearable Hearing Aids		listed, no stanceJun 1, 2026payer document
UnitedHealthcareHearing Aids and Devices Including Wearable, Bone- Anchored, and Semi-Implantable (for Tennessee Only) (CS052TN.T)
Wearable Hearing Aids		listed, no stanceJun 1, 2026payer document
UnitedHealthcareHearing Aids and Devices Including Wearable, Bone-Anchored, and Semi-Implantable (CS052.V)
Wearable Hearing Aids		listed, no stanceJun 1, 2026payer document
UnitedHealthcareHearing Aids and Devices Including Wearable, Bone-Anchored, and Semi-Implantable (2026T0396II)
Wearable Hearing Aids		listed, no stanceMar 1, 2026payer document
UnitedHealthcareHearing Aids and Devices Including Wearable, Bone-Anchored, and Semi-Implantable (for Idaho Only) (CS052ID.D)
Wearable Hearing Aids		listed, no stanceJun 1, 2026payer document
UnitedHealthcareHearing Aids and Devices Including Wearable, Bone-Anchored, and Semi-Implantable (for Indiana Only) (CS052IN.10)
Wearable Hearing Aids		listed, no stanceJun 1, 2026payer document
UnitedHealthcareHearing Aids and Devices Including Wearable, Bone-Anchored, and Semi-Implantable (for Louisiana Only) (CS052LA.O)
Wearable Hearing Aids		listed, no stanceAug 1, 2025payer document
UnitedHealthcareHearing Aids and Devices Including Wearable, Bone-Anchored, and Semi-Implantable (for New Mexico Only) (CS052NM.D)
Wearable Hearing Aids		listed, no stanceJun 1, 2026payer document
UnitedHealthcareHearing Aids and Devices Including Wearable, Bone-Anchored, and Semi-Implantable (for North Carolina Only) (CSNCT0396.10)
Wearable Hearing Aids		listed, no stanceJun 1, 2026payer document
UnitedHealthcareHearing Aids and Devices Including Wearable, Bone-Anchored, and Semi-Implantable (for Ohio Only) (CS052OH.F)
Wearable Hearing Aids		listed, no stanceSep 1, 2026payer document
UnitedHealthcareHearing Aids and Devices Including Wearable, Bone-Anchored, and Semi-Implantable (for Pennsylvania Only) (CS052PA.S)
Wearable Hearing Aids		listed, no stanceJun 1, 2026payer document
UnitedHealthcareHearing Instruments and Devices Including Wearable, Bone-Anchored, and Semi-Implantable (for Kentucky Only) (CS052KY.13)
Wearable Hearing Aids		listed, no stanceAug 1, 2026payer document

Recent prior-auth changes

  • Jul 1, 2026: PA removed, Humana
  • Mar 1, 2025: PA removed, Rocky Mountain Health Plans

Medicaid fee-for-service

Prior authorization required or conditional in IN, LA, MS, NY, OH, VA, WV.

  • IL: $752.00 (dme), effective Jan 1, 2026
  • KS: $412.50 (default, Exempt Physician), effective Mar 1, 2006
  • LA: $1107.46 (dme), effective Jul 1, 2014
  • MS: $577.50 (comprehensive), effective Jan 1, 1994
  • NE: $859.27 (hearing_aid), effective Jul 1, 2024
  • VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026
  • WY: $0.00 (outpatient_hospital_apc, Children's Hospitals), effective Apr 1, 2026

From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.