Hearing Aids and Devices Including Wearable, Bone-Anchored, and Semi-Implantable (for New Jersey Only)
New Jersey–specific medical policy governing coverage and medical necessity criteria for wearable hearing aids, bone-anchored hearing aids (implantable and nonimplantable), semi-implantable electromagnetic hearing aids, and related devices; affects providers and members in New Jersey covered by UnitedHealthcare.
Updated language to clarify the listed indications are proven and medically necessary for hearing loss in an individual who is not a candidate for an air conduction hearing aid when used in accordance with FDA labeled indications, contraindications, warnings, and precautions.
Medical records documentation language added specifying records must fully support medical necessity and may be required for review.
Removed list of applicable CPT/HCPCS codes for fitting and testing of hearing aids (92590–92595, S0618, V5010, V5011, V5014, V5020, V5264, V5265, V5275).
Noted that CPT/HCPCS codes 0951T–0955T and V5282 are not on the New Jersey Medicaid Fee Schedule and therefore may not be covered by NJ Medicaid.
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