Hearing Aids and Devices Including Wearable, Bone-Anchored, and Semi-Implantable (for Louisiana Only)

Coverage Summary

This policy (CSOS2LA.O) is a Louisiana-specific UnitedHealthcare coverage criteria document for hearing aids and related devices, effective August 1, 2025. It applies to Louisiana Medicaid beneficiaries and includes EPSDT-specific requirements for beneficiaries <21 years of age.

State-specific coverage is mixed: wearable air-conduction hearing aids and several bone-conduction and semi-implantable devices are identified as proven/medically necessary when used per FDA labeling, while certain device types (laser/light-based aids, intraoral bone conduction aids, and totally implanted middle ear systems) are listed as unproven / not medically necessary due to insufficient evidence.

The policy lists covered device categories (wearable air-conduction, non-implantable bone conduction headband/adhesive devices, semi-implantable electromagnetic middle-ear devices, implantable bone-anchored and partially implantable magnetic-coupling systems, and totally implantable systems) and provides specific coding updates (added CPT codes 0951T–0955T per the 08/01/2025 revision).

Quick reference thresholds, device examples, and coding (Louisiana)

Louisiana EPSDT significant hearing loss threshold> 20 dB HL (average hearing level in the range 250–2000 Hz)

Age/scope for EPSDT coverageApplies to eligible beneficiaries under 21 years of age (EPSDT eligible)

Device categories covered (examples)Wearable air-conduction; non-implantable bone conduction (headband/softband/ADHEAR); bone-anchored implantable (BAHA, Bonebridge, Osia, Cochlear Baha Attract); semi-implantable electromagnetic (Vibrant Soundbridge/Maxum); partially implantable magnetic-coupling devices

Device-specific PTA/BC thresholds (common examples)Typical PTA BC eligibility: ≤45 dB HL for many devices; ≤55 dB HL for some processors/Osia; ADHEAR BC PTA ≤25 dB HL; Osia/ Bonebridge BC PTA ≤55 dB HL

Normal-hearing definition for SSD indicationsAC PTA ≤20 dB HL (0.5, 1, 2, 3 kHz) in the hearing ear

Interaural symmetry requirement for bilateral implants<10 dB average difference (0.5,1,2,3/4 kHz) or <15 dB at individual frequencies

Applicable CPT/HCPCS highlights and effective dateMultiple implant and hearing-aid codes listed (e.g., 69710, 69714, 69716–69730, L8690–L8694, 92590–92595, V5xxx series). CPT codes 0951T–0955T added to policy as of 08/01/2025

Medical-Necessity Criteria

State-Specific Coverage for Hearing Aids (Louisiana)

Hearing Aids are provided only for EPSDT-eligible Louisiana beneficiaries under 21 and require specified audiometric documentation.

Member is an eligible beneficiary under 21 years of age (EPSDT eligible)

Significant hearing loss documented by audiometric data from both an ear specialist (otologist) and a hearing aid provider

Hearing loss greater than 20 decibels average hearing level in the range 250-2000 Hz is considered significant> 20 dB HL (250-2000 Hz)

Non State-Specific Medically Necessary Devices

When used according to FDA-labeled indications/warnings/precautions, the following device categories are considered proven and medically necessary for individuals who are not candidates for air-conduction hearing aids:

Applicable Codes

Bone Anchored Hearing Aids (BAHA) CPT/HCPCS/OthermixedCovered

69710	Implantation or replacement of electromagnetic bone conduction hearing device in temporal bone
69714	Implantation, osseointegrated implant; skull; with percutaneous attachment to external speech processor
69716	Implantation, osseointegrated implant; skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or resulting in removal of less than 100 sq mm surface area of bone deep to the outer cranial cortex
69717	Replacement (including removal of existing device), osseointegrated implant; skull; with percutaneous attachment to external speech processor
69719	Replacement (including removal of existing device), osseointegrated implant; skull; with magnetic transcutaneous attachment to external speech processor; within the mastoid and/or involving a bony defect less than 100 sq mm surface area of bone deep to the outer cranial cortex
69729	Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor; outside of the mastoid and resulting in removal of >= 100 sq mm surface area of bone deep to the outer cranial cortex
69730	Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect >= 100 sq mm surface area of bone deep to the outer cranial cortex
L8690	Auditory osseointegrated device, includes all internal and external components
L8691	Auditory osseointegrated device, external sound processor, excludes transducer/actuator, replacement only, each
L8694	Auditory osseointegrated device, transducer/actuator, replacement only, each

1–10 of 11

1/2

Fitting and Testing of Hearing Aids (CPT/V/Codes)mixedCovered

92590	Hearing aid examination and selection; monaural
92591	Hearing aid examination and selection; binaural
92592	Hearing aid check; monaural
92593	Hearing aid check; binaural
92594	Electroacoustic evaluation for hearing aid; monaural
92595	Electroacoustic evaluation for hearing aid; binaural
V5030	Hearing aid, monaural, body worn, air conduction
V5040	Hearing aid, monaural, body worn; bone conduction
V5050	Hearing aid, monaural, in the ear
V5060	Hearing aid, monaural, behind the ear

1–10 of 18

1/2

Semi-Implantable / Totally Implantable Procedures (CPT/T Codes)mixedCovered

69799	Unlisted procedure, middle ear
0951T	Totally implantable active middle ear hearing implant; initial placement; including mastoidectomy; placement of and attachment to sound processor
0952T	Totally implantable active middle ear hearing implant; revision or replacement, with mastoidectomy and replacement of sound processor
0953T	Totally implantable active middle ear hearing implant; revision or replacement, without mastoidectomy and replacement of sound processor
0954T	Totally implantable active middle ear hearing implant; replacement of sound processor only, with attachment to existing transducers
0955T	Totally implantable active middle ear hearing implant; removal, including removal of sound processor and all implant components
S2230	Implantation of magnetic component of semi-implantable hearing device on ossicles in middle ear
V5095	Semi-implantable middle ear hearing prosthesis

Fitting and Testing of Hearing Aids (CPT/V/Codes)mixedCovered

92590	Hearing aid examination and selection; monaural
92591	Hearing aid examination and selection; binaural
92592	Hearing aid check; monaural
92593	Hearing aid check; binaural
92594	Electroacoustic evaluation for hearing aid; monaural
92595	Electroacoustic evaluation for hearing aid; binaural
V5030	Hearing aid, monaural, body worn, air conduction
V5040	Hearing aid, monaural, body worn; bone conduction
V5050	Hearing aid, monaural, in the ear
V5060	Hearing aid, monaural, behind the ear

1–10 of 18

1/2

Fitting and Testing of Hearing Aids - Asterisked (may not be on LA Medicaid Fee Schedule)mixed

S0618	Audiometry for hearing aid evaluation to determine the level and degree of hearing loss (asterisk indicates not on state fee schedule)
V5010	Assessment for hearing aid (asterisked)
V5011	Fitting/orientation/checking of hearing aid (asterisked)
V5020	Conformity Evaluation (asterisked)
V5265	Ear mold/insert; disposable, any type (asterisked)
V5275	Ear impression, each (asterisked)

Wearable Hearing Aids and Related V codes (selected)mixedCovered

V5255	Hearing aid, digital, monaural, ITC
V5261	Hearing aid, digital, binaural, BTE
V5254	Hearing aid, digital, monaural, CIC (asterisked where noted)

Semi-Implantable / Totally Implantable Procedures (CPT/T Codes)mixedCovered

69799	Unlisted procedure, middle ear
0951T	Totally implantable active middle ear hearing implant; initial placement; including mastoidectomy; placement of and attachment to sound processor
0952T	Totally implantable active middle ear hearing implant; revision or replacement, with mastoidectomy and replacement of sound processor
0953T	Totally implantable active middle ear hearing implant; revision or replacement, without mastoidectomy and replacement of sound processor
0954T	Totally implantable active middle ear hearing implant; replacement of sound processor only, with attachment to existing transducers
0955T	Totally implantable active middle ear hearing implant; removal, including removal of sound processor and all implant components
S2230	Implantation of magnetic component of semi-implantable hearing device on ossicles in middle ear
V5095	Semi-implantable middle ear hearing prosthesis

Codes Not on Louisiana Medicaid Fee Schedule (asterisked codes) - may not be covered by state programmixed

*69710	Implantation or replacement of electromagnetic bone conduction hearing device in temporal bone (asterisk indicates not on state fee schedule)
*S0618	Audiometry for hearing aid evaluation to determine the level and degree of hearing loss
*V5010	Assessment for hearing aid
*V5011	Fitting/orientation/checking of hearing aid
*V5020	Conformity Evaluation
*V5265	Ear mold/insert; disposable, any type (asterisked)
*V5275	Ear impression, each (asterisked)
*S2230	Implantation of magnetic component of semi-implantable hearing device on ossicles in middle ear (asterisked variant appears in codes list)
*L8693	Auditory osseointegrated device abutment, any length, replacement only (asterisked)
*V5242	Hearing aid, analog, monaural, CIC (completely in the ear) (asterisked)

1–10 of 30

1/3

Added/Updated CPT CodesCPT

0951T	Added per 08/01/2025 policy update
0952T	Added per 08/01/2025 policy update
0953T	Added per 08/01/2025 policy update
0954T	Added per 08/01/2025 policy update
0955T	Added per 08/01/2025 policy update

Provider Actions & Billing Rules

Documentation Required

Audiometric documentation and specialist evaluation required

For Louisiana EPSDT beneficiaries (<21), provide audiometric documentation from both an ear specialist (otologist) and a hearing aid provider showing average hearing loss >20 dB HL across 250–2000 Hz. Include the specialist evaluation and corresponding audiogram records to support medical necessity.

Audiometric data from an otologist and a hearing aid provider
Average hearing loss >20 dB HL measured across 250–2000 Hz

Prior Authorization

Equipment upgrades treated as new requests

Treat equipment upgrades as new service requests for authorization. Upgrades or changes in the member’s medical condition or equipment needs must meet the same prior authorization criteria as an initial request.

Background, Evidence Summary, and Definitions

The policy defines device categories across wearable air-conduction hearing aids, non-implantable bone conduction devices (headband/adhesive/softband), semi-implantable electromagnetic middle-ear implants (e.g., Vibrant Soundbridge), implantable bone-anchored systems (percutaneous and transcutaneous, e.g., BAHA, Bonebridge, Osia), partially implantable magnetic-coupling systems, intraoral bone-conduction devices (SoundBite), laser/light-driven contact hearing aids (Earlens), and totally implantable middle-ear systems (Esteem, Carina).

Evidence cited includes Cochrane and other systematic reviews and randomized or observational studies: RCT evidence supports benefit of conventional hearing aids for mild–moderate loss (Cochrane Ferguson et al. 2017); systematic reviews and cohort/observational studies report audiologic improvements, speech-in-noise benefits, and patient satisfaction for bone-anchored and partially implantable devices but note generally low-to-moderate quality and limited comparative/long-term data; semi-implantable devices have systematic-review support for improved speech perception; totally implantable and intraoral systems show mixed or low-quality evidence with safety/complication concerns.

Evidence Source	Key Finding
Cochrane review (Ferguson et al. 2017)
Hearing aids for mild to moderate adult hearing loss improve hearing-specific and general health-related quality of life and listening ability (5 RCTs, 825 participants); supports first-line provision of hearing aids.
Systematic reviews / studies for BAHA / Bone conduction devices
Multiple systematic reviews and observational studies report audiological benefits (improved speech discrimination in noise, improved thresholds), variable effects on localization, and generally low-to-weak quality evidence but overall reasonable support for BAHA in conductive/mixed loss and SSD indications.
Earlens clinical trials (Gantz 2017; Arbogast 2019)
Single-arm trials and multicenter studies showed safety and significant functional gain and improved word recognition/APHAB scores (e.g., 28–32 percentage point APHAB improvements vs unaided); FDA de novo/510(k) clearance supported by these data.
Totally implantable middle ear devices (Carina, Esteem) - reviews and cohort studies
Evidence limited and mixed: some studies report functional gain and improved speech measures but substantial device-specific complications, failures, explants, and inconsistent results; overall quality low and insufficient for broad conclusions.
Intraoral (SoundBite) studies
Case series and small crossover studies in SSD report improved APHAB and patient satisfaction; device manufacturing ceased after 2015; evidence low quality with selection bias and limited follow-up.
Partially implantable bone conduction devices (e.g., BAHA Attract, Bonebridge, Osia, Sophono)
Systematic reviews and cohort studies report improved audiological outcomes, high patient satisfaction, and low-to-moderate complication rates, but long-term comparative randomized data are lacking and evidence quality often low to very low.
Systematic reviews / HTAs (AAO-HNS, ECRI, Hayes, Ontario Health)
Professional society statements and HTAs conclude bone conduction and active middle ear implants are appropriate for selected patients (conductive/mixed loss, SSD, or when conventional aids insufficient), noting available FDA clearances and need for adherence to indications; HTAs report likely improvements in thresholds, speech perception and hearing-specific QoL versus no intervention.
Non-implantable bone-conduction devices and headband/softband studies (softband, ADHEAR, BAHA SoundArc)
Prospective and cohort studies show significant aided threshold and speech audiometry improvements in children and adults; ADHEAR and softband provide comparable benefits to passive implants for selected patients and are options when surgery is not desired.
Meta-analyses / systematic reviews of active transcutaneous and passive transcutaneous devices (Magele 2019; Cooper & McDonald 2017; Dimitriadis 2016)
Reviews report beneficial audiological performance and high satisfaction with active transcutaneous devices, low major complication rates, and favorable functional gain, but evidence limited to cohort studies and case series.
BAHA bilateral vs unilateral reviews (Janssen, Colquitt)
Observational studies suggest bilateral BAHA can provide additional audiologic benefit (improved thresholds, speech in quiet/noise) though evidence is weak and caution advised in interpretation.
FDA clearance and device-specific regulatory references
Multiple devices (Vibrant Soundbridge, Maxum, BAHA models, Bonebridge, Osia, Earlens, SoundBite, Esteem) have FDA clearances/approvals with device-specific labeled indications and audiologic selection criteria cited in the regulatory documentation.

Conductive Hearing Loss: Occurs when sound is not conducted efficiently through the outer ear canal to the eardrum and ossicles of the middle ear; often correctable medically or surgically.

Sensorineural Hearing Loss (SNHL): Occurs when there is damage to the inner ear (cochlea) or nerve pathways; often permanent and not typically correctable medically or surgically.

Mixed Hearing Loss: Combination of conductive and sensorineural loss affecting outer/middle ear plus inner ear or auditory nerve.

Hearing Aid: A sound-amplifying device designed to aid people with hearing impairment; includes wearable, semi-implantable electromagnetic devices, and bone-anchored systems as classified by the FDA.

Policy History / Coding Update

08/01/2025coding_updateLatest

Added CPT codes 0951T–0955T; supporting info archived previous policy CSOS2LA.N

08/01/2025policy_historyLatest

Applicable CPT codes updated to reflect quarterly edits; added 0951T, 0952T, 0953T, 0954T, and 0955T (supporting information archived from prior policy CSOS2LA.N)

Device-specific FDA Indications and Audiologic Selection Criteria

Device use is indicated when ALL device-specific audiologic and patient criteria (including FDA-labeled selection criteria and age/threshold cutoffs) are met:

Vibrant Soundbridge selection criteria (Adults ≥18): Pure tone air conduction threshold levels by frequency within provided ranges500 Hz: 30-65 dB; 1000 Hz: 40-75 dB; 1500 Hz: 45-80 dB; 2000 Hz: 45-80 dB; 3000 Hz: 50-85 dB; 4000 Hz: 50-85 dB

Also: audiologic results consistent with moderate to severe SNHL; word recognition score ≥50%; psychologically/motivationally suitable; normal middle ear anatomy

BAHA / Bone-anchored systems (general FDA indications): Patients with malformations of the external ear, chronically draining ear, pure tone threshold hearing loss of ≥45 dB, and/or inability or unwillingness to use an air conduction hearing aidPTA AC ≥45 dB for initial BAHA indication; pediatric clearance for children ≥5 years (1999)

Bilateral implantation for BAHA: Moderate to severe bilateral symmetrical conductive hearing loss or mixed hearing loss with average bone conduction thresholds better than 45 dB HLSymmetry defined as <10 dB average or <15 dB at individual frequencies (500,1000,2000,4000 Hz)

BAHA for Single-Sided Deafness (SSD): Unilateral sensorineural deafness in one ear with the other ear having normal hearingHearing ear AC PTA ≤20 dB HL (0.5,1,2,3 kHz)

Intended as alternative for patients who cannot/will not use AC CROS

Partially implantable devices (examples: Sophono Otomag Alpha 1, Cochlear Baha Attract, Bonebridge, Osia): Patients with conductive or mixed hearing loss who can benefit from amplification; device-specific PTA BC thresholds and age cutoffs applyExamples: Otomag: PTA BC better than 45 dB HL; Baha BP100: BC ≤45 dB HL for BP100, ≤55 dB HL for BP1100; Osia: BC PTA ≤55 dB HL

Age thresholds vary: Otomag implant ≥5 years; Bonebridge and Osia ≥12 years; Cochlear Baha Attract ≥5 years; bilateral fitting intended for symmetric losses with interaural BC differences <10 dB average or <15 dB at individual frequencies; recommend prior trial of appropriately fit AC or BC hearing aids when recommended

Non-implantable bone-conduction devices and headband/softband: Intended for moderate to severe conductive losses; useful when implant not possible or not chosenBAHA Softband cleared for children <5 years; ADHEAR: BC PTA ≤25 dB HL; normal hearing AC PTA ≤20 dB HL (0.5,1,2,3 kHz)

Light-driven contact hearing aid (Earlens) indications: Adults ≥18 with mild to severe sensorineural hearing impairment who can benefit from amplificationProvides amplification 125 Hz–10,000 Hz per FDA labeling

FDA cleared via 510(k)/de novo for ages ≥18

Totally implantable middle ear hearing systems (e.g., Cochlear Carina, Esteem): FDA-approved devices exist but clinical evidence limited and mixed with device-specific adverse events and failures

Reported complications (e.g., Esteem chorda tympani nerve damage ~30%); evidence limited by lack of controlled trials

Intraoral bone conduction hearing aid (SoundBite) context: SoundBite received FDA clearance in 2011 but manufacturing ceased after company bankruptcy in 2015

Evidence from case series and small crossover studies with low quality