Cochlear Implants (Non-hybrid and Hybrid)
Defines UnitedHealthcare's medical policy on cochlear implants, including applicability by age and laterality, references InterQual clinical criteria for medical necessity, states where policy does not apply, benefit considerations for DME vs medical-surgical, applicable CPT/HCPCS codes, and FDA informational links.
04/01/2026: Template Update; removed content/language pertaining to the state of Louisiana.
10/01/2025: Added language indicating the Medical Policy does not apply to the state of Nebraska; refer to state-specific policy.
09/01/2025: Added Medical Records Documentation Used for Reviews language clarifying that coverage is determined by federal/state/contractual requirements and that records may be required.
Coverage Summary
This policy addresses coverage for Cochlear Implants (Non-hybrid and Hybrid). UnitedHealthcare defines applicability by age and laterality and references InterQual clinical criteria to determine medical necessity. The policy is mixed in stance and applies effective 2025-09-01 with last review on 2026-04-01.
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