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TO:  Audiology Providers

RE:  Coverage update for V5264

Effective July 1, 2025, the Alabama Medicaid Agency increased the number of ear molds allowed per year. Procedure code V5264 will:

·         be limited to recipients ages 0 to 20 years,

·         allow 8 units per calendar year, and

·         allow replacements once every 3 months.

Providers with billing questions may contact the Gainwell Technology Provider Assistance Center at

1-800-688-7989.

The Current Procedural Terminology (CPT) and Current Dental Terminology (CDT) codes descriptors, and other data are copyright © 2025 American Medical Association and © 2025 American Dental Association (or such other date publication of CPT and CDT). All rights reserved. Applicable FARS/DFARS apply.