Expanded Medicare Coverage for Cochlear Implants

Expanded Medicare Coverage for Cochlear Implants

Effective September 26, 2022, the Centers for Medicare & Medicaid Services (CMS) expanded Medicare coverage for treatment of bilateral pre- or post-linguistic, sensorineural, moderate-to-profound hearing loss in qualifying Medicare recipients with hearing test scores between 41-60 percent.

Qualifying criteria includes:

• Diagnosis of bilateral moderate-to-profound sensorineural hearing impairment with limited benefit from appropriate hearing (or vibrotactile) aids;
• Cognitive ability to use auditory clues and a willingness to undergo an extended program of rehabilitation;
• Freedom from middle ear infection, an accessible cochlear lumen that is structurally suited to implantation, and freedom from lesions in the auditory nerve and acoustic areas of the central nervous system;
• No contraindications to surgery; and
• The device must be used in accordance with Food and Drug Administration (FDA)-approved labeling.

Information provided by CMS. Full memo available here.

Learn more about the Cochlear Implant Center at Westchester Medical Center.