V5215 Hearing aid binaural itc/bteHearing aid, contralateral routing system, binaural, itc/bte
Status N: non-covered service.
19 of 21 payer prior-auth lists that name V5215 require prior authorization or set conditions: Blue Cross Blue Shield of Arizona (AZ Blue), Molina Complete Care (Virginia), Molina Healthcare of California, Molina Healthcare of Idaho, Molina Healthcare of Iowa, Molina Healthcare of Michigan, Molina Healthcare of Mississippi, Molina Healthcare of Nevada, Molina Healthcare of New Mexico, Molina Healthcare of Ohio, Molina Healthcare of Utah, Passport by Molina Healthcare (Kentucky), Rocky Mountain Health Plans, UnitedHealthcare Community Plan.
| Payer | Plan | State | Prior auth | Conditions | Since | Source |
|---|---|---|---|---|---|---|
| Blue Cross Blue Shield of Arizona (AZ Blue) | Federal Employee Program (FEP) | AZ | prior auth under conditions | FEP Standard and Basic only | Sep 1, 2026 | Federal Employee Program (FEP) Prior Authorization Requirements Code List (Updated 09/01/2026) |
| Molina Complete Care (Virginia) | Medicaid | VA | prior auth required | Apr 1, 2025 | Virginia Medicaid PA Code Matrix and Virginia code/benefit exceptions, effective Q2 2025 | |
| Molina Healthcare of California | Medicaid | CA | prior auth required | Apr 1, 2026 | Medicaid Prior Auth (PA) Code Matrix (California), effective Q2 2026 | |
| Molina Healthcare of Idaho | Medicaid | ID | prior auth required | Jan 1, 2025 | Idaho Medicaid Prior Auth (PA) Code Matrix and Idaho code/benefit exceptions, Q1 2025 | |
| Molina Healthcare of Iowa | Medicaid | IA | prior auth required | Jul 1, 2023 | IA Prior Authorization Matrix, effective Q3 2023 | |
| Molina Healthcare of Michigan | Exchange | MI | prior auth required | Jul 1, 2021 | Molina Healthcare of Michigan PA Matrix, effective 7/1/2021 | |
| Molina Healthcare of Michigan | Medicaid | MI | prior auth required | Jul 1, 2026 | Molina Healthcare of Michigan PA Matrix 2026-Q3 | |
| Molina Healthcare of Mississippi | Medicaid | MS | prior auth required | Jan 1, 2025 | Mississippi Medicaid Prior Auth (PA) Code Matrix and exceptions, effective Q1 2025 | |
| Molina Healthcare of Nevada | Medicaid | NV | prior auth required | Oct 1, 2022 | Medicaid Prior Auth (PA) Code Matrix, effective Q4 2022 | |
| Molina Healthcare of New Mexico | Medicaid | NM | prior auth required | Jul 1, 2026 | New Mexico Medicaid Prior Auth (PA) Code Matrix, effective July 1, 2026 | |
| Molina Healthcare of Ohio | Medicaid and MyCare Ohio (MMP) Medicaid | OH | prior auth required | Oct 1, 2023 | Molina Healthcare of Ohio Prior Authorization (PA) Code List, effective 2023-10-01 | |
| Molina Healthcare of Ohio | Exchange | OH | prior auth required | Oct 1, 2023 | Molina Healthcare of Ohio Prior Authorization (PA) Code List, effective 2023-10-01 | |
| Molina Healthcare of Utah | Medicaid | UT | prior auth required | Jan 1, 2025 | Utah Medicaid Prior Auth (PA) Code Matrix and Utah code/benefit exceptions, Q1 2025 | |
| Passport by Molina Healthcare (Kentucky) | Medicaid | KY | prior auth required | Jul 1, 2026 | Kentucky Medicaid Prior Auth (PA) Code Matrix and Kentucky PA Code Exceptions, effective Q3 2026 | |
| Rocky Mountain Health Plans | Rocky Mountain Health Plans CHP+ | CO | prior auth required | Oct 1, 2026 | Rocky Mountain Children’s Health Plan - prior authorization Effective October 1, 2026 | |
| UnitedHealthcare Community Plan | Maryland HealthChoice | MD | prior auth required | Sep 1, 2026 | Prior authorization requirements for UnitedHealthcare Community Plan of Maryland Effective September 1, 2026 | |
| UnitedHealthcare Community Plan | Massachusetts OneCare | MA | prior auth under conditions | Prior authorization is required for replacements when billed with modifier radionavigation aids. | Nov 1, 2025 | Prior authorization requirements for Massachusetts OneCare Effective November 1, 2025 |
| UnitedHealthcare Community Plan | Massachusetts Senior Care Options (SCO) | MA | prior auth under conditions | Prior authorization is required for replacements when billed with modifier radionavigation aids. | Nov 1, 2025 | CPT® is a registered trademark of the American Medical Association. Prior authorization requirements for Massachusetts Senior Care Options Effective November 1, 2025 |
| UnitedHealthcare Community Plan | Massachusetts Senior Care Options (SCO) and OneCare | MA | prior auth required | Oct 1, 2026 | Prior authorization requirements for Massachusetts MA SCO OneCare Effective October 1, 2026 |
V5215 appears in 16 coverage policies from Aetna, Blue Cross & Blue Shield of Mississippi, Blue Cross & Blue Shield of Rhode Island, Premera Blue Cross, UnitedHealthcare.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Bone-Anchored Hearing Aids (0403) | listed, no stance (range V5008-V5299) | Jul 22, 2026 | payer document |
| Aetna | Tinnitus Treatments (0406) | not covered (range V5010-V5267) | Jul 10, 2026 | payer document |
| Blue Cross & Blue Shield of Mississippi | Prosthetics (L.1.04.401) | covered if criteria are met | payer document | |
| Blue Cross & Blue Shield of Rhode Island | Hearing Aid Coverage Commercial Products | listed, no stance | Jan 1, 2026 | payer document |
| Premera Blue Cross | Hearing Aids (Excludes Implantable Devices) Page | 7 of 19 | ∞ | listed, no stance | Sep 1, 2026 | payer document |
| UnitedHealthcare | Hearing Aids and Devices Including Wearable, Bone- Anchored, and Semi-Implantable (for Kansas Only) (CS052KS.04) Wearable Hearing Aids | listed, no stance | Sep 1, 2026 | payer document |
| UnitedHealthcare | Hearing Aids and Devices Including Wearable, Bone- Anchored, and Semi-Implantable (for Nebraska Only) (CS052NE.V) Wearable Hearing Aids | listed, no stance | Jun 1, 2026 | payer document |
| UnitedHealthcare | Hearing Aids and Devices Including Wearable, Bone- Anchored, and Semi-Implantable (for Tennessee Only) (CS052TN.T) Wearable Hearing Aids | listed, no stance | Jun 1, 2026 | payer document |
| UnitedHealthcare | Hearing Aids and Devices Including Wearable, Bone-Anchored, and Semi-Implantable (CS052.V) Wearable Hearing Aids | listed, no stance | Jun 1, 2026 | payer document |
| UnitedHealthcare | Hearing Aids and Devices Including Wearable, Bone-Anchored, and Semi-Implantable (2026T0396II) Wearable Hearing Aids | listed, no stance | Mar 1, 2026 | payer document |
| UnitedHealthcare | Hearing Aids and Devices Including Wearable, Bone-Anchored, and Semi-Implantable (for Idaho Only) (CS052ID.D) Wearable Hearing Aids | listed, no stance | Jun 1, 2026 | payer document |
| UnitedHealthcare | Hearing Aids and Devices Including Wearable, Bone-Anchored, and Semi-Implantable (for Louisiana Only) (CS052LA.O) Wearable Hearing Aids | listed, no stance | Aug 1, 2025 | payer document |
| UnitedHealthcare | Hearing Aids and Devices Including Wearable, Bone-Anchored, and Semi-Implantable (for New Mexico Only) (CS052NM.D) Wearable Hearing Aids | listed, no stance | Jun 1, 2026 | payer document |
| UnitedHealthcare | Hearing Aids and Devices Including Wearable, Bone-Anchored, and Semi-Implantable (for Ohio Only) (CS052OH.F) Wearable Hearing Aids | listed, no stance | Sep 1, 2026 | payer document |
| UnitedHealthcare | Hearing Aids and Devices Including Wearable, Bone-Anchored, and Semi-Implantable (for Pennsylvania Only) (CS052PA.S) Wearable Hearing Aids | listed, no stance | Jun 1, 2026 | payer document |
| UnitedHealthcare | Hearing Instruments and Devices Including Wearable, Bone-Anchored, and Semi-Implantable (for Kentucky Only) (CS052KY.13) Wearable Hearing Aids | listed, no stance | Aug 1, 2026 | payer document |
Prior authorization required or conditional in IN, LA, NE, OH, WA, WV, WY.
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.