ModifiedUnitedHealthcarePolicy ENT 007.37

Hearing Aids and Devices Including Wearable, Bone-Anchored, and Semi-Implantable

UnitedHealthcare clinical policy governing medical necessity and coverage rationale for wearable air-conduction hearing aids, bone-anchored systems, semi-implantable electromagnetic hearing aids, intraoral, laser/light-based, and totally implanted middle ear systems; affects providers submitting coverage requests and members seeking these devices.

Policy Summary

PayerUnitedHealthcare

PolicyHearing Aids and Devices Including Wearable, Bone-Anchored, and Semi-Implantable

Policy CodePolicy ENT 007.37

Change TypeUpdated applicable CPT listadded temporary codes 0951T–0955T

Effective DateJuly 1, 2025

Next Review DateN/A

Key ActionVerify member benefits and submit prior authorization using the updated applicable CPT list (including 0951T–0955T) and document device-specific FDA selection criteria and required audiometry.

SourceLink

POLICY UPDATE CHANGES

Applicable CPT codes were updated and new temporary codes 0951T–0955T were added.

5proven device types

3unproven device types

July 1, 2025effective date

0951T–0955Tnew temp codes

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Coverage Criteria and Medical Necessity

Medically Necessary Devices (when ACHA not suitable)

Covered when ALL of the following are met (as stated in Coverage Rationale):

Proven and medically necessary devices when used according to FDA-labeled indications for individuals who are not candidates for air-conduction hearing aids: Bilateral or unilateral bone conduction hearing aids utilizing a headband or adhesive (without osseointegration); Bilateral fully or partially implantable bone-anchored hearing aids for conductive or mixed hearing loss in both ears; Semi-implantable electromagnetic hearing aid for sensorineural hearing loss; Unilateral fully or partially implantable bone-anchored hearing aids for sensorineural hearing loss in one ear; Unilateral fully or partially implantable bone-anchored hearing aids for conductive or mixed hearing loss in one or both ears.FDA labeled indications

Applies when member is not a candidate for air-conduction hearing aid

Unproven / Not Medically Necessary Devices

Devices considered unproven / not medically necessary due to insufficient evidence:

Unproven devices: Laser or light-based hearing aids; Intraoral bone conduction hearing aids; Totally implanted middle ear hearing systems.insufficient evidence of efficacy

These are listed as unproven and not medically necessary.

General evidence-driven guidance

Evidence-based summaries and implied coverage considerations:

Conventional hearing aids: Randomized trials and systematic reviews support conventional hearing aids for adults with mild to moderate sensorineural hearing loss as first-line management due to improvements in hearing-related quality of life and listening ability.

Supports trial of conventional devices before advanced/implantable options.

Partially implantable/transcutaneous bone conduction devices

Transcutaneous and partially implantable bone conduction devices:

Active transcutaneous devices: Systematic reviews report beneficial audiological performance, high patient satisfaction, and low complication rates for active transcutaneous bone conduction devices in conductive/mixed hearing loss or single-sided deafness; reported incidence rates: minor events ~1 per 9.9 person‑years; major events ~1 per 148.9 person‑years.

Evidence limited to cohort and case‑control studies.

Passive transcutaneous devices (pTCBI): Reviews summarize favorable audiological outcomes, low-to-moderate complication rates (major complications ~5.2%, minor complications ~13.1%) and good patient satisfaction; literature reports ~482 pTCBIs overall, but studies are small and heterogeneous.

Careful patient selection and further robust trials recommended.

Implantable bone-anchored hearing aids

Bone-anchored hearing aids (BAHA/implanted BCHAs):

BAHA efficacy: Systematic reviews report improved speech discrimination in noise and subjective quality-of-life benefits for single-sided deafness and bilateral conductive losses; sound localization benefit is inconsistent.

Evidence includes observational studies and systematic reviews; overall strength variable.

Bilateral vs unilateral BAHA: Some observational studies indicate audiologic and localization benefits of bilateral BAHA compared to unilateral BAHA but evidence is weak and interpretation requires caution.

Potential increased adverse-event risk with bilateral implantation noted.

Limited/insufficient evidence categories

Other device categories with limited/insufficient evidence:

Laser/light-based hearing aids: Descriptive technology summaries exist (e.g., Earlens CHD) but outcome data in these sections are limited or insufficient to establish effectiveness.

Evidence limited by lack of controlled comparative trials.

Totally implantable middle ear systems: Devices such as Esteem and Carina are described; published studies are often single-arm, small, and yield conflicting findings with reported adverse events; evidence quality insufficient for broad conclusions.

Randomized controlled trials lacking.

Intraoral bone conduction (SoundBite): Prospective case series report subjective benefit for single-sided deafness but studies lack control groups, have small samples, and show limitations (dropouts, device production cessation) that reduce evidentiary strength.

Insufficient quality evidence to support routine use.

Covered when device-label criteria met

Coverage and appropriateness align with device-specific FDA indications and AAO-HNS guidance; coverage when device labeling criteria met.

Standard eligibility for implantable or bone-conduction devices: Patient meets device-specific FDA selection criteria (age, audiologic thresholds/frequencies, word recognition score where specified), AND patient has conductive or mixed hearing loss or SSD consistent with device indication, AND conventional amplification has been attempted and found insufficient or is contraindicated (as applicable).see device-specific thresholds

AAO-HNS supports active middle ear implants for adults with moderate to severe loss and BCHD for conductive/mixed loss and select SSD when indicated.

Evidence limitations

Evidence limitations that affect coverage decisions

Evidence concerns: Most effectiveness studies are single-arm, small sample size, and lack randomized or concurrent control groups; results are heterogeneous with some device‑specific adverse event signals (e.g., device failure, chorda tympani/taste disturbance, facial weakness).

These limitations may prompt requests for additional documentation or restrict coverage to FDA-labeled indications.

Device-specific medical necessity criteria

Covered when ALL of the following device-specific criteria are met (examples collated from device labeling):

General device eligibility

PTA bone-conduction threshold: Threshold requirements vary by device: e.g., ≤45 dB HL for many BAHA/BP100/Baha 4/5; ≤55 dB HL for some processors (BP110/Power, Osia/Osia2 examples); up to ≤65 dB HL for superpower processors; ADHEAR ≤25 dB HL for its indications.device-specific
See labeled device requirements.
SSD criteria: For single-sided deafness, contralateral ear AC PTA should be ≤20 dB HL (0.5, 1, 2, 3 kHz); devices intended for SSD may be indicated when the patient cannot or will not use AC CROS alternatives.AC PTA ≤20 dB HL
Per device labeling.

The policy identifies several device categories as unproven and not medically necessary because the available evidence is insufficient to establish efficacy. Specifically, laser/light-based hearing aids (e.g., light‑driven contact devices that transmit energy to a tympanic‑membrane transducer), intraoral bone conduction hearing aids (dental‑appliance coupled transducers such as SoundBite), and totally implantable middle ear hearing systems (fully implanted devices with internal processors and drivers) are listed as unproven and not medically necessary for treating hearing loss.

Frequency Modulated (FM) systems are treated as accessories rather than integral hearing aids and are therefore excluded from coverage. The policy states these devices do not prevent, diagnose, or treat a sickness or injury and are not considered integral to a hearing aid.

When devices or indications lack controlled comparative evidence—such as novel intraoral transducers or laser/light systems—the policy may deny coverage or treat the technology as investigational. In such cases, the medical record should include stronger justification and objective outcomes because the literature is frequently limited by single‑arm designs, small samples, short follow‑up, and no concurrent control group.

Non‑surgical bone conduction options using a Baha Softband or headband are explicitly described as applications that do not require implantation. Per device labeling, when a non‑implantable headband/softband provides adequate amplification, surgical implantation is not indicated.

For clarity, the policy reiterates the device categories considered unproven: laser/light‑based hearing aids, intraoral bone conduction hearing aids, and totally implantable middle ear hearing systems. These categories are listed as not medically necessary due to insufficient evidence of efficacy.

Evidence for intraoral bone conduction hearing aids is limited and of low quality. Available studies are small, often single‑arm or case‑series designs with short follow‑up and incomplete randomization or control groups. Although some prospective series report subjective benefit and high patient satisfaction, these methodological limitations mean the evidence is insufficient to support routine coverage.

The policy notes that devices or device features without adequate evidence of benefit may require additional documentation to justify medical necessity. Examples include novel intraoral transducers and laser/light‑based systems, where the lack of randomized or concurrent control data increases the likelihood of investigational status or denial unless stronger objective data are provided.

The document references FDA approvals or clearances for specific devices — for example, Esteem (totally implantable middle ear system), SoundBite (intraoral bone conduction system), and Earlens (light‑based contact hearing device) — but does not create separate coverage rules for those clearances within this excerpt. Consult device labeling and the full policy for device‑specific coverage determinations.

Applicable Codes and Clinical Thresholds

Bone Anchored Hearing Aids (BAHA) - CPTCPT

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 greater than or equal to 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 greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex.

Fitting/Testing and Totally Implantable Middle Ear - CPTCPT

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.
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.

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BAHA, Wearable, and Fitting Codes - HCPCS/CPT/V codesmixed

L8690	Auditory osseointegrated device, includes all internal and external components.
L8691	Auditory osseointegrated device, external sound processor; excludes transducer/actuator; replacement only, each.
L8693	Auditory osseointegrated device abutment; any length, replacement only.
L8694	Auditory osseointegrated device, transducer/actuator, replacement only, each.
L8692	Auditory osseointegrated device, external sound processor, used without osseointegration, body worn, includes headband or other means of external attachment.
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.
V5014	Repair/modification of a hearing aid.
V5020	Conformity Evaluation.

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Semi-implantable and Wearable Hearing Aids - HCPCS/V codesmixed

S2230	Implantation of magnetic component of semi-implantable hearing device on ossicles in middle ear.
V5095	Semi-implantable middle ear hearing prosthesis.
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.
V5070	Glasses, air conduction.
V5080	Glasses, bone conduction.
V5267	Hearing Aid or assistive listening device/supplies/accessories, not otherwise specified (requires manual review).
V5298	Hearing aid, not otherwise classified.

Wearable Hearing Aid Descriptors - V codesHCPCS

V5242	Hearing aid, analog, monaural, CIC.
V5243	Hearing aid, analog, monaural, ITC.
V5244	Hearing aid, digitally programmable analog, monaural, CIC.
V5245	Hearing aid, digitally programmable, analog, monaural, ITC.
V5246	Hearing aid, digitally programmable analog, monaural, ITE.
V5247	Hearing aid, digitally programmable analog, monaural, BTE.
V5248	Hearing aid, analog; binaural, CIC.
V5249	Hearing aid, analog; binaural, ITC.
V5250	Hearing aid, digitally programmable analog, binaural, CIC.
V5251	Hearing aid, digitally programmable analog, binaural, ITC.

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Degree of hearing loss (dBHL) — classification ranges

Normal-10 to 15 dB HL

Slight16 to 25 dB HL

Mild26 to 40 dB HL

Moderate41 to 55 dB HL

Moderately severe56 to 70 dB HL

Severe71 to 90 dB HL

Prior Authorization, Documentation, and Billing Guidance

Prior Authorization

Prior Authorization Required

Prior authorization may be required for implantable and specialized hearing device procedures. Verify member-specific benefits and prior authorization requirements prior to scheduling. Refer to the member's benefit plan document to determine coverage for semi-implantable electromagnetic hearing aids, wearable devices, and implants.

Prior authorization may be required for implantable devices and specialized procedures listed in the Applicable Codes section (including newly added temporary CPT codes 0951T–0955T).
Benefit verification must confirm whether the member's plan covers Semi-Implantable Electromagnetic Hearing Aids (SEHA), wearable hearing aids (including non-implantable bone conduction aids using headbands or adhesive), and fully/partially implantable bone-anchored hearing aids.

Prior Authorization

Member Benefit & Prior Authorization Verification

Verify member-specific benefits and prior authorization requirements using the member's plan document before initiating evaluation or scheduling procedures.

Check whether SEHA, wearable hearing aids, and implantable devices are included in the member's covered benefits.

Background and Definitions

Background: Hearing aids amplify or transmit sound to assist people with hearing impairment. Air‑conduction hearing aids are standard first‑line devices for losses not correctable by medical or surgical means. Bone conduction and semi‑implantable devices provide alternatives when air‑conduction hearing aids are not suitable or tolerated; coverage and appropriateness should align with device labeling, audiometric thresholds, age limits, and prior attempts at conventional amplification when recommended.

Conductive Hearing Loss — definition and clinical note

DefinitionConductive hearing loss occurs when sound is not conducted efficiently through the outer ear canal to the eardrum and ossicles of the middle ear

Clinical consequenceUsually involves reduction in sound level or ability to hear faint sounds

ReversibilityThis type of hearing loss can often be corrected medically or surgically

Sensorineural Hearing Loss — definition

Policy Revision History

2025-07-01policy_revisionLatest

Effective 2025-07-01: Applicable CPT codes were updated for quarterly edits and temporary CPT codes 0951T–0955T were added; supporting information archived and prior version ENT 007.36 archived.

Policy Summary

PayerUnitedHealthcare

PolicyHearing Aids and Devices Including Wearable, Bone-Anchored, and Semi-Implantable

Policy CodePolicy ENT 007.37

Change TypeUpdated applicable CPT listadded temporary codes 0951T–0955T

Effective DateJuly 1, 2025

Next Review DateN/A

SourceLink

On This Page

Age and bilateral symmetry:

Age requirements per device (examples: BP100 for ≥5 years; Bonebridge/Osia for ≥12 years); bilateral fitting intended when BC thresholds are symmetric (average difference <10 dB or <15 dB at individual frequencies).

Per device labeling.

Pure tone average and frequency-based thresholds — device-specific values

Common PTA bone-conduction cutoffMany devices require PTA BC ≤45 dB HL (measured at 0.5, 1, 2, 3 kHz)

Extended processor cutoffsSome sound processors permit PTA BC up to 55 dB HL (e.g., power processors) or higher for super‑power processors

Vibrant Soundbridge frequency selection ranges500 Hz: 30–65 dB; 1000 Hz: 40–75 dB; 1500 Hz: 45–80 dB; 3000/4000 Hz: 50–85 dB

SSD contralateral AC requirementFor SSD indications, contralateral ear AC PTA should be ≤20 dB HL (0.5,1,2,3 kHz)

PTA bone-conduction hearing threshold — common device cutoffs

Common device cutoff (many BAHA/BP100)PTA bone-conduction ≤45 dB HL (measured at 0.5, 1, 2, and 3 kHz)

Some processors (power models)PTA BC eligibility up to 55 dB HL for select processors (e.g., BP110/Power)

Super‑power processorsDevice labeling permits PTA BC up to ~65 dB HL for designated super‑power processors (e.g., Cordelle II, Baha 5 SuperPower)

ADHEAR non‑implantable exampleADHEAR system PTA BC requirement: ≤25 dB HL for its indications

PTA air-conduction threshold (contralateral ear for SSD)

Definition of normal contralateral hearing for SSDPure tone average air-conduction (0.5, 1, 2, 3 kHz) ≤20 dB HL defines normal hearing for the contralateral ear in SSD indications

Measurement frequencies specifiedPTA measured at 0.5, 1, 2, and 3 kHz per device labeling for SSD determinations

Use with CROS alternativesSSD indication may be applied when patient cannot or will not use an AC CROS and contralateral AC PTA is ≤20 dB HL

Confirm prior authorization requirements and any plan-specific limitations or age restrictions.

Prior Authorization

Device-Specific Prior Authorization

Document that the patient meets device-specific FDA indications and labeling when requesting authorization for a device. Include age, audiometric thresholds (PTA/BC), laterality/symmetry, word recognition scores, and any contraindications (e.g., for SSD/CROS candidates).

Reference device-specific FDA selection criteria (for example, Vibrant Soundbridge and Maxum labeling and indications).
For BAHA/Bonebridge/Osia/other devices, document PTA AC and/or BC thresholds, symmetry between ears, and applicable age criteria.
For SSD indications, document normal hearing in the contralateral ear per the device labeling (e.g., PTA AC ≤ 20 dB HL where specified).

Billing Rule

Use Updated CPT/HCPCS Codes for Prior Authorization

Use the current, updated list of applicable CPT and HCPCS codes when submitting prior authorization requests to avoid processing delays or denials.

Include newly added temporary CPT codes 0951T, 0952T, 0953T, 0954T, 0955T where applicable.
Include relevant BAHA and fitting/testing codes (e.g., 69710–69730 series, 92590–92595) and HCPCS L8690–L8694, L8692, and V5xxx codes as applicable.

Documentation Required

Medical Records and Documentation Risk

Medical records and required clinical documentation may be requested to determine whether the member meets clinical coverage criteria; lack of documentation may result in denial.

Provide complete medical records, including prior audiologic testing, hearing aid trials, operative reports (if replacing devices), and clinical notes documenting functional impairment.
Absence of required records or incomplete documentation is a risk factor for denial of the authorization request.

Denial Risk

Evidence Limitations and Potential for Additional Documentation

The evidence base for some devices (for example, laser/light-driven systems) is limited by lack of concurrent control groups or other methodological weaknesses; this may prompt requests for additional documentation or lead to noncoverage.

When the published evidence lacks randomized or concurrent control groups, reviewers may require more robust clinical documentation or may determine the technology is experimental/unproven for certain indications.
Be prepared to supply objective audiometric outcomes and validated patient-reported outcome measures when available.

Documentation Required

Required Clinical Documentation

Required clinical documentation should be submitted with authorization requests and includes diagnostic audiometry results and demonstration of prior use or trial of non-implantable amplification when applicable.

Diagnostic audiometry: PTA bone-conduction (BC) and air-conduction (AC) thresholds at 0.5, 1, 2, and 3 kHz (or as device labeling specifies).
Word recognition scores using recorded materials where indicated (e.g., Vibrant Soundbridge requires ≥ 50% WRS).
Laterality/symmetry: document interaural differences per device labeling (e.g., BC symmetry <10 dB average or <15 dB at individual frequencies where specified).
Documentation that conventional amplification was attempted and either failed or was contraindicated; include duration and fitting details of prior hearing aid use, per AAO-HNS recommendations.

Prior Authorization

Trial of Non-Implantable Amplification Prior to Implantation

Prior experience with appropriately fitted air-conduction or bone-conduction hearing aids is recommended before implantation for many devices; document attempts, trial duration, and fitting parameters.

Document trial of conventional hearing aids (air- or bone-conduction) unless contraindicated or not feasible.
For BAHA/Bonebridge/Osia and similar devices, record that the patient had experience with appropriately fitted hearing aids when labeling recommends it, and describe reasons for moving to implantable options (e.g., poor benefit, anatomy, chronic drainage).
Equipment upgrades or replacement procedures are treated as new services and require the same documentation and criteria as initial requests.

DefinitionSensorineural hearing loss (SNHL) results from damage to the inner ear (cochlea) or nerve pathways to the brain

Typical courseMost SNHL is permanent and cannot be medically or surgically corrected

PrevalenceSNHL is the most common type of permanent hearing loss

Mixed Hearing Loss — definition

DefinitionMixed hearing loss is a combination of conductive and sensorineural components (damage in outer/middle ear plus inner ear or nerve)

ImplicationBoth conductive and sensorineural elements should be considered when selecting amplification or surgical options

AssessmentAudiometric testing differentiates air- and bone-conduction thresholds to identify mixed loss

Hearing Aids — definition including semi‑implantable electromagnetic and bone‑anchored

General definitionHearing aids are sound‑amplifying devices designed to aid people with hearing impairment; includes conventional air‑conduction and certain semi‑implantable electromagnetic and bone‑anchored devices classified by FDA

Semi‑implantable electromagnetic categorySemi‑implantable electromagnetic (direct‑drive middle ear) devices (e.g., Vibrant Soundbridge, Maxum) are FDA‑classified hearing aids with internal transducers coupled to ossicles

Bone‑anchored categoryBone‑anchored hearing aids (BAHAs/BCHAs) transmit sound via bone conduction and include percutaneous, transcutaneous (magnetic), fully implantable, and non‑implantable headband/adhesive options

Laser or Light‑Based Hearing Aids — definition (Earlens‑type systems)

DefinitionLaser or light‑based hearing aids (e.g., Earlens CHD) use a behind‑the‑ear processor that converts sound to infrared light transmitted to a tympanic‑membrane transducer which vibrates the TM to produce sound

ComponentsSystem consists of a BTE light‑based sound processor and a custom tympanic membrane transducer placed deep in the ear canal

Distinct mechanismUnlike traditional air‑conduction hearing aids, transmission is via light pulses rather than amplified air sound

Totally Implantable Middle Ear Hearing Systems — definition

DefinitionTotally implantable middle ear hearing systems are fully implanted devices with internal sound processor, sensor, and driver components that deliver mechanical or electrical signals to the inner ear without external microphones or speakers

ExamplesDevices include the Esteem prosthetic hearing restoration device and Carina (developmental history noted)

Power supplySome totally implantable devices use long‑life internal batteries (e.g., Esteem battery life up to nine years)

Bone‑Anchored Hearing Aids (BAHAs) / Bone Conduction Hearing Aids (BCHAs) — definition and scope

DefinitionBone‑anchored hearing aids (BAHAs/BCHAs) transmit sound via bone conduction and encompass percutaneous implants, partially implantable transcutaneous devices (magnetic coupling), fully implantable systems, and non‑implantable headband/adhesive devices

IndicationsUsed for conductive or mixed hearing loss and selected single‑sided deafness cases when air‑conduction devices are unsuitable

Delivery optionsIncludes implanted osseointegrated abutments, magnetic transcutaneous implants, and non‑surgical softband/headband/adhesive fittings for trials or non‑implant candidates

Intraoral Bone Conduction Hearing Aid (IOBC / SoundBite) — definition

DefinitionIntraoral bone conduction hearing aid (IOBC / SoundBite) is an in‑mouth transducer coupled via a dental appliance that transmits sound through bone conduction for single‑sided deafness

Device descriptionNot implanted in the skull; uses a dental appliance to couple transducer to teeth and provides subjective hearing benefit in case series

Evidence noteClinical evidence is limited (small studies, lack of randomized controls) and considered insufficient quality to establish effectiveness

Single‑sided deafness (SSD) — definition and contralateral hearing criteria

Definition of SSDSingle‑sided deafness (SSD) is unilateral profound sensorineural deafness in one ear with normal hearing in the contralateral ear

Normal hearing contralateral criterionNormal contralateral hearing is defined as AC PTA ≤20 dB HL measured at 0.5, 1, 2, and 3 kHz

Clinical useBAHA/BCHA SSD indications apply when patient cannot or will not use AC CROS alternatives

Bone conduction pure tone average (PTA) eligibility — device‑specific thresholds

Common device PTA BC eligibilityMany devices require PTA bone‑conduction thresholds ≤45 dB HL (0.5,1,2,3 kHz)

Higher cutoffs for power processorsSome processors allow PTA BC up to 55 dB HL (BP110/Power) and super‑power processors up to ~65 dB HL per labeling

ADHEAR exampleADHEAR non‑implantable system requires PTA BC ≤25 dB HL for its indications

Measurement frequenciesPTA BC measured at 0.5, 1, 2, and 3 kHz per device labeling

Symmetrical bone‑conductive thresholds — definition

Definition of symmetrySymmetrical bone‑conductive thresholds: less than a 10 dB average difference between ears at 0.5, 1, 2, and 3 kHz

Alternate single‑frequency ruleOr less than a 15 dB difference at individual frequencies

Implication for bilateral fittingSymmetry criteria determine candidacy for bilateral implantation or bilateral fitting of processors

Single‑sided deafness (SSD) — additional definition entry

DefinitionSingle‑sided deafness (SSD) denotes unilateral profound sensorineural loss with normal hearing in the opposite ear

Normal contralateral thresholdContralateral ear AC PTA ≤20 dB HL (measured at 0.5,1,2,3 kHz) qualifies as normal hearing for SSD indications

Device applicabilitySSD indications for BAHA/BCHAs often apply when AC CROS is not acceptable or effective for the patient