(1) The agency's payment for purchased hearing aids includes:
(a) A prefitting evaluation;
(b) An ear mold; and
(c) A minimum of three post-fitting consultations.
(2) The agency denies payment for hearing aids and/or services when claims are submitted without the prior authorization number, when required, or the appropriate diagnosis or procedure code(s).
(3) The agency does not pay for hearing aid charges paid by insurance or other payer source.
(4) To receive payment, the provider must keep documentation in the client's medical file to support the medical necessity for the specific make and model of the hearing aid ordered for the client. This documentation must include the record of the audiology testing providing evidence that the client's hearing loss meets the eligibility criteria for a hearing aid.
