Earmolds for Hearing Aids: Billing Codes, Medicaid Payments and Materials

The two earmold billing codes: V5264 and V5265

Earmolds have their own pair of HCPCS codes, separate from the hearing aid. In the CMS October 2026 code file, V5264 reads "Ear mold/insert, not disposable, any type" and V5265 reads "Ear mold/insert, disposable, any type." The only line between the two is whether the mold is disposable.

"Any type" means the code doesn't name a material, a style or a maker. A custom acrylic shell and a silicone mold bill under the same code if both are reusable. That matters when you read a bill or an insurer's statement: the code tells you a mold was supplied, not which one.

What Medicaid paid for earmolds, 2018 to 2024

Federal Medicaid claims data give the only national payment series we hold for earmolds. From January 2018 to December 2024, Medicaid paid $7,457,604.09 on 156,129 claim lines for V5264, or $47.77 per line. For V5265 it paid $4,437,532.52 on 71,530 lines, or $62.04 per line. These are amounts paid by Medicaid per claim line, not what a patient or a cash buyer pays, and they aren't a fee in any one state.

The two codes are billed by very different numbers of providers. V5264 has 303 billers with an identifier, and the largest one accounts for 5.4% of the money paid. V5265 has 26, and one biller accounts for 80.1% of payments, so the V5265 figure mostly reflects that single biller's claims. 2024 figures are preliminary, and cells suppressed at the source are left out.

For the 2023-2024 window alone, the V5264 figure is $51.87 per line; that line sits with every other hearing aid code on our hearing aids cost page.

Earmold materials named by Oticon and Phonak

Two makers' documents, read on November 3, 2026, name the materials in the second table. Oticon's earmold page for professionals lists three: OtoTherm, a thermoplastic that Oticon says softens at body temperature, hard acrylic and soft silicone. It adds that its molds and materials that touch the skin are "tested to be biologically safe for permanent skin contact according to the ISO-10993 Standard."

Phonak's pediatric earmold order form, listed in the sources below and dated January 16, 2025, offers acrylic and silicone, and ties some options to one material: Soft Coat for acrylic only, Tube Lock for silicone only. The same form lists styles from canal to skeleton, half-shell and carved full shell. Both documents are written for hearing care professionals, who place the order.

How VA handles earmolds

For veterans with VA hearing aids, the VA Denver Logistics Center page on repairs covers earmolds in its own line. "The ear mold can be sent in for cleaning/re-tubing, if necessary." A damaged mold is a different case: the page says ear molds "that are damaged cannot typically be repaired" unless they are fully integrated, with the receiver encased in the mold, and that "all others must be replaced by your local VA Audiology and Speech Pathology Service."

So a cracked custom mold goes to the local VA audiology clinic rather than into the repair box. The page gives no separate earmold charge; VA's hearing aid benefit is on our VA hearing aids page, and repair costs outside VA are on hearing aid repair.