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Section 4/ Part 1
Effective Date: May 1, 1998

Hearing aids

Rehabilitation Services (RS) policy and procedure

Counselors shall discuss provision of hearing aids with clients and help clients determine which aids and audiological services best meet their needs. Clients (age 18 or older) who do not wish to wear aids when there would be no improvement in the ability to understand speech may make that determination. Or they may elect to use only one hearing aid for sound awareness. They may make this choice even though an audiologist or licensed hearing aid specialist may have recommended two aids. Counselors should assure that clients have the information needed to make an informed choice in such circumstances. Trial periods may be appropriate to help some clients determine if they can benefit from aids.

Clients should be shown the Client Hearing Aid Satisfaction Questionnaire. See Section 8 / Part 25. It should be explained that no payment will be made to the vendor until the client is satisfied. The consumer should complete the questionnaire and the audiologist should return the completed questionnaire to RS along with the billing.

Purchase of hearing aids should be done within an Individualized Plan for Employment (IPE), either as a service provided to an accepted client (Statuses 14, 16 or 18) or as part of an extended evaluation (Status 06). Hearing aids should not be provided in Status 02.

Use of the state audiological consultant is permitted whenever a counselor needs clarification of hearing aid recommendations. (Approval by the state audiological consultant is not required.) When requesting information or advice from the consultant, Sections I (Medical and Hearing Examinations) and II (Certification for Hearing Aid Dispensing) of the Hearing Aid Provision Forms and other physician reports or relevant materials should be attached to the Report of Contact (see Section 8 / Part 40) for the state consultant.

Prior to dispensing a hearing aid, a hearing evaluation must be completed by an audiologist or a licensed hearing aid specialist if an audiologist is not available in the community. The hearing aid provider may recommend a medical examination by a licensed physician as required by the federal Food and Drug Administration to assure that all medically treatable conditions which may affect hearing are identified and treated before the hearing aid is purchased. The FDA requires the exam to be completed within the previous six months. Such a medical exam is required for all children. The FDA regulations permit a fully informed adult (age 18 or older) to sign a waiver statement declining the medical evaluation. Section II of the Hearing Aid Forms lists the eight medical conditions which indicate that referral for a medical exam is appropriate.

Hearing Aid Forms

Hearing Aid Provision, Medical Examination - Section Ia: If the hearing aid provider discovers a hearing disorder with an unresolved medical problem, a medical exam by a physician is required. Persons under the age of 18 must be examined by a physician prior to purchasing a hearing aid.

Hearing Aid Provision, Hearing Examination - Section Ib: This examination must be completed prior to dispensing a hearing aid. This section is completed by a clinical audiologist [Certificate of Clinical Competence (CCC-A) and state licensed] or a hearing aid specialist licensed to dispense hearing aids if an audiologist is not available in the community. This examination should consist of two CPT procedures:

  • Comprehensive audiometry threshold evaluation and speech recognition
    925570000 at $52.93
  • Tympanometry (impedance testing)
    925670000 at $7.56

    • Hearing Aid Provision, Certification for Hearing Aid Dispensing - Section II: The hearing aid provider identifies the hearing aid recommended and expected benefits and also certifies that the client has been advised to consult with a licensed physician (preferably an ear specialist) before the hearing aid is dispensed if the client has any of the eight medical conditions listed.

    Hearing Aid Evaluation - Section III: The vendor evaluates the hearing aid fitting near the end of the 30-day trial period. The vendor should examine the client. If the client, vendor or counselor determine that the hearing aid is unsatisfactory, the vendor is to be paid only the trial fee for $50 for each hearing aid returned.

    Client Hearing Aid Satisfaction Questionnaire - Section IV: The client completes this questionnaire after the trial period. This questionnaire, Hearing Aid Evaluation - Section III Form and the manufacturer’s invoice are submitted to the counselor for payment.

    The fee schedule separates costs for dispensing and for the hearing aid equipment.

  • When a device is returned as unsatisfactory, RS will pay only $50 (no dispensing or equipment fees).
  • The fee for the hearing aids will be reimbursed at the manufacturer’s invoice cost. A copy of the actual invoice is required and should be provided by the vendor attached to the billing statement.
  • The dispensing fee increases as the complexity of the device increases. A more complex device requires additional vendor equipment for adjustments and more follow-up visits.

    • Tier I: Traditional linear hearing aid
    Estimated cost for hearing aid*: $400
    Dispensing fee for the first aid: $250
    Dispensing fee for the second aid: $100

    Tier II: Advanced signal processing aid
    Estimated cost for hearing aid*: $450
    Dispensing fee for the first aid: $480
    Dispensing fee for the second aid: $200

    Tier III: Digital programmable aid
    Estimated cost for hearing aid*: $850
    Dispensing fee for the first aid: $800
    Dispensing fee for the second aid: $400

    * Use this estimated cost to prepare the authorization. This may be adjusted to a higher or lower cost at the time of payment depending upon the actual invoice cost. Note that economic need procedures must be applied to the purchase of hearing aids, and clients will be expected to contribute according to their ability to do so.
       
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