Aetna modified CPB 0870 for automated audiometry, effective January 5, 2026. CPT codes 0208T and 0209T are not covered under this policy. Here's what billing teams need to act on now.
Aetna, a CVS Health company, updated Clinical Policy Bulletin 0870 to explicitly classify automated audiometry — both self-administered and non-audiologist-administered — as experimental, investigational, or unproven. The two codes in scope, 0208T (automated pure tone air audiometry without an audiologist) and 0209T (automated pure tone air and bone audiometry without an audiologist), are now designated non-covered under the Aetna automated audiometry coverage policy. If your practice or audiology group bills these codes to Aetna, expect claim denial.
Quick-Reference Table
| Field | Detail |
|---|---|
| Payer | Aetna, a CVS Health company |
| Policy | Automated Audiometry — CPB 0870 |
| Policy Code | CPB 0870 Aetna |
| Change Type | Modified |
| Effective Date | January 5, 2026 |
| Impact Level | High |
| Specialties Affected | Audiology, ENT, Primary Care, Occupational Medicine |
| Key Action | Remove CPT 0208T and 0209T from Aetna charge capture immediately and reroute patients requiring audiometric testing to a licensed audiologist |
Aetna Automated Audiometry Coverage Criteria and Medical Necessity Requirements 2026
The Aetna automated audiometry coverage policy is straightforward — and not in your favor if you've been billing 0208T or 0209T.
Aetna's position is that automated audiometry has not been adequately validated as equivalent to audiometry performed by a licensed audiologist. That's the core medical necessity argument, and it's the reason both codes land in the non-covered column. Aetna is not saying audiometry itself is unproven. They're saying the automated, non-audiologist-administered version doesn't meet the bar.
This matters because the distinction is clinical, not just administrative. Aetna won't reimburse automated audiometry regardless of the clinical setting or the indication. There's no scenario described in CPB 0870 where 0208T or 0209T would pass a medical necessity review. The coverage policy doesn't carve out exceptions for occupational hearing screenings, telehealth contexts, or remote monitoring programs.
If your team has been billing these codes under the assumption that automated tools are a clinically equivalent — and therefore reimbursable — substitute for audiologist-administered testing, CPB 0870 closes that door. Prior authorization won't save you here. These codes aren't denied for lack of prior auth — they're non-covered outright.
Aetna Automated Audiometry Exclusions and Non-Covered Indications
Aetna classifies two specific types of automated audiometry as experimental, investigational, or unproven under CPB 0870:
Self-administered automated audiometry. Any audiometric testing the patient performs themselves — regardless of the device or software — does not meet Aetna's medical necessity standard. CPT 0208T and 0209T both fall here.
Non-audiologist-administered automated audiometry. Testing administered by someone other than a licensed audiologist also fails coverage. This includes medical assistants, technicians, nurses, or any other clinical staff who aren't credentialed audiologists.
The real issue here is that this policy catches a wide range of settings. Telehealth audiology platforms, occupational health screening programs, and primary care hearing checks using tablet-based audiometry tools are all at risk. If the test is automated and there's no audiologist running it, Aetna won't cover it — and bills for 0208T or 0209T will be denied.
There's no language in CPB 0870 suggesting Aetna will revisit this classification based on new evidence submissions or appeals for specific cases. The "experimental" designation is a hard stop under the current policy.
Coverage Indications at a Glance
| Indication | Status | Relevant Codes | Notes |
|---|---|---|---|
| Automated pure tone audiometry (air only), self-administered or by non-audiologist | Not Covered / Experimental | 0208T | Considered experimental, investigational, or unproven; claim denial expected |
| Automated pure tone audiometry (air and bone), self-administered or by non-audiologist | Not Covered / Experimental | 0209T | Considered experimental, investigational, or unproven; claim denial expected |
| Audiometry performed by a licensed audiologist | Not addressed in CPB 0870 | See standard audiometry codes | Standard audiologist-administered testing is outside scope of this exclusion |
Aetna Automated Audiometry Billing Guidelines and Action Items 2026
The effective date of January 5, 2026 has passed. If you haven't acted yet, do it now.
| # | Action Item |
|---|---|
| 1 | Pull your Aetna claims for CPT 0208T and 0209T dating back to January 5, 2026. Any claims submitted after that date are at high risk for denial or recoupment. Run a payer-specific report in your billing system today. |
| 2 | Remove 0208T and 0209T from your Aetna charge capture templates. These codes should not appear as billable options for Aetna patients until CPB 0870 changes. Flag them as non-covered in your practice management system. |
| 3 | Audit any automated audiometry billing guidelines you've built into your workflows. If your team routes automated screening results through 0208T or 0209T for any Aetna plan — commercial, Medicare Advantage, or otherwise — those workflows need to stop. |
| 4 | Redirect patients to a licensed audiologist for covered audiometric testing. Aetna's coverage policy does not exclude audiometry broadly — it excludes the automated, non-audiologist-administered version. If audiometric data is clinically necessary, a licensed audiologist administering the test is your path to reimbursement. |
| 5 | Do not attempt prior authorization as a workaround. Prior auth is not the barrier here. CPB 0870 designates these codes as experimental — that classification means the service is excluded from coverage regardless of auth status. Prior authorization requests for 0208T and 0209T won't change the outcome. |
| 6 | Check your other payers. Aetna's position on automated audiometry isn't unique in the industry. If you're billing 0208T or 0209T to other commercial payers, verify their coverage policies before your next claim cycle. A similar non-covered designation from a second major payer would double your exposure. |
| 7 | If you operate occupational health, telehealth audiology, or remote hearing screening programs, loop in your compliance officer now. These settings are exactly where 0208T and 0209T tend to get billed, and CPB 0870 closes coverage for all of them under Aetna. Your compliance officer should assess the financial exposure and decide whether any patient notification or refund obligations apply. |
| Previous Version | Current Version |
|---|---|
| Coverage is considered experimental and investigational for all indications | Coverage is considered medically necessary when specific criteria are met |
| Prior authorization is not required | Prior authorization is required for initial treatment |
| Documentation must include clinical history | Documentation must include clinical history |
| Re-review every 24 months | Re-review every 12 months with updated clinical documentation |
CPT, HCPCS, and ICD-10 Codes for Automated Audiometry Under CPB 0870
CPB 0870 covers two CPT codes. There are no covered codes under this policy — both codes in scope are non-covered. There are no HCPCS or ICD-10 codes listed in CPB 0870.
Not Covered / Experimental CPT Codes
| Code | Type | Description | Reason |
|---|---|---|---|
| 0208T | CPT | Pure tone audiometry (threshold), automated; air only — without an audiologist | Experimental, investigational, or unproven; not covered for indications listed in CPB 0870 |
| 0209T | CPT | Pure tone audiometry (threshold), automated; air and bone — without an audiologist | Experimental, investigational, or unproven; not covered for indications listed in CPB 0870 |
Both 0208T and 0209T share the same non-coverage rationale: Aetna has not accepted evidence that automated audiometry equals audiologist-administered audiometry in clinical validity. Until that evidence threshold is met and CPB 0870 is updated, these codes stay non-covered.
If your billing team has been treating 0208T and 0209T as reimbursable under Aetna — perhaps because the codes exist in your system and weren't flagged — this policy update is the signal to make that correction. Codes existing in the CPT book doesn't mean any given payer covers them. That's standard billing practice, but it catches teams off guard more than it should.
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