CPT Code Billing for Visual Reinforcement Audiometry (VRA)

Disclaimer

This content is provided for general educational purposes only and does not constitute billing, coding, or legal advice. CPT coding requirements, reimbursement policies, and payer guidelines may change and can vary by insurer and jurisdiction. Clinicians and practices should consult payer-specific policies, professional guidance, or qualified billing specialists to ensure accurate coding and compliance.

Visual Reinforcement Audiometry is a commonly used behavioral hearing test within a pediatric VRA system, designed to measure hearing thresholds in infants and young children. Although most pediatric audiologists might be familiar with VRA testing, questions about VRA CPT codes and how to bill for VRA testing are a common question in our inbox. So, in this overvie, we'll address the most frequently asked questions about how to bill for VRA and which CPT codes are typically used.

What CPT code is used for Visual Reinforcement Audiometry?

The CPT code most commonly associated with visual reinforcement audiometry is 92579. This code is used for behavioral audiometric testing that relies on visual reinforcement techniques and is typically applied when testing infants or young children who are not developmentally ready for conditioned play audiometry.

Is there one CPT code that covers all VRA system testing?

No. There is no single CPT code that universally covers all testing performed during a VRA session. Billing for visual reinforcement audiometry is based on the testing method performed, not the VRA system or equipment used. While 92579 is often appropriate, additional audiometric CPT codes may be used depending on how thresholds are obtained and payer-specific guidance.

When should CPT code 92582 be used instead of a VRA CPT code?

CPT code 92582 is used for conditioned play audiometry and should only be billed when play-based testing is performed. It should not be used for visual reinforcement audiometry unless the child has transitioned developmentally to play audiometry during the session.

Does soundfield versus ear-specific testing affect how to bill for VRA?

In most cases, billing does not change solely based on whether testing is completed in the soundfield or with ear-specific transducers. However, documentation should clearly describe how stimuli were presented, how responses were obtained, and which behavioral method was used during visual reinforcement audiometry.

What documentation is important when billing for VRA testing?

Clinical documentation should include the patient’s age and developmental level, the behavioral testing method used, the reliability of responses, and any limitations encountered during testing. Clear documentation supports medical necessity and is especially important when billing for pediatric visual reinforcement audiometry.

Do payer rules vary for VRA CPT codes?

Yes. Reimbursement and coverage for visual reinforcement audiometry vary by insurance carrier, state Medicaid program, and individual payer policy. Practices should regularly review payer guidelines and confirm requirements such as prior authorization when applicable.

Does the type of VRA system affect billing?

No. CPT codes describe the clinical service performed, not the technology or reinforcement system used. Billing should always reflect the testing procedure and behavioral method rather than the specific VRA system.