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December 2016 Texas Medicaid Provider Procedures Manual

Vision and HearingServices Handbook : 2 Nonimplantable Hearing Aid Devices and Related Services : 2.2 Services, Benefits, Limitations, and Prior Authorization : 2.2.3 Audiology and Audiometry Evaluation and Diagnostic Services : Otological Examinations
Otological examinations are a benefit when medically necessary and provided by a Medicaid-enrolled physician licensed to perform this service.
Procedure codes 92504 and 92505 are benefits for otological examinations.
An otological examination may also include physician evaluation and management (E/M) services provided to diagnose or treat medical conditions.
Refer to:
Subsection, “Group Clinical Visits” in Medical and Nursing Specialists, Physicians, and Physician Assistants Handbook (Vol. 2, Provider Handbooks) for information about medically necessary physician E/M services.

Texas Medicaid & Healthcare Partnership
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