Note: People with an approved hearing loss claim who require a new hearing aid as of November 18, 2024 will be provided with hearing services through our refreshed hearing services program.
*Applicable to cases before November 18, 2024*
Noise-induced hearing loss program of care
Our former noise-induced hearing loss program of care provided comprehensive hearing services to reduce the impact of people’s hearing loss. It included services such as assessment, dispensing and fitting and follow-up visits up to one-year post-assessment.
Hearing health care providers must be registered with us to deliver the program.
Transition scenarios and examples
Scenario one
I dispensed hearing aids to my patient on September 1, 2023 in the noise-induced hearing loss program of care. This means the initial year of service ended on September 1, 2024. They came back for maintenance services on November 18, 2024. How should I bill for this visit?
Since the maintenance service visit is within the new hearing services program, you can consider this visit as part of the program’s ongoing bundle and you can bill the first payment for this bundle.
Continue to deliver services, as required by the patient for optimal hearing, and you can bill again in a minimum of 180 days, which would be May 18, 2025 in this case.
Scenario two
My patient visited the clinic for hearing services on October 1, 2024 and is requesting additional follow-up services on December 1, 2024. What does this mean for billing?
You cannot bill us for the December 1st appointment as it is within three months from your last fee-for-service date in the old program of care, October 1st.
You can start billing for the ongoing bundle in the hearing services program starting January 1, 2025, as this date would be three months after your last fee-for-service date on October 1, 2024.
Scenario three
I have a new patient requesting services at my clinic on December 1, 2024. They were last seen at a different hearing health care clinic on November 18, 2024. What does this mean for billing?
If the patient’s last clinic billed for the ongoing bundle based on the November 18th service date, you cannot bill for the ongoing bundle until after May 18, 2025 (180 days from the last billable service date). Refer to the next section on when a patient changes clinic for more information.
Resources
- (completed at the 90-day follow-up visit)
- Fee schedule