CMS has confusing benefits for hearing loss. CMS by law does not cover "hearing aids" for deafness. However, some years ago, CMS ruled that a cochlear implant falls outside the definition of hearing aid. (Apparently, the deceased originalists who wrote the Medicare statute in 1965 would have taken that meaning.)
Anyway, CMS does have a benefit, under an NCD, for cochlear implants. CMS is considering whether to make the benefit more liberal. CMS has published a public request to do so. Right now, CMS covers cochlear implants when hearing scores are <40% (but can cover 40-60% patients under clinical trials). CMS would raise the regular eligibility requirement from 40% of hearing to 60% of hearing.
- See the CMS website for NCD activities under current public comment here.
- Note that public comment regarding whether to revise amyloid PET scan benefits is open, until July 15.
- See the proposed decision memo for cochlear implants (CAG 00107R) here.
- Public comment is open for 30 days.
- See the 9-page letter request here.
- Note that WHETHER TO ACCEPT THE REQUEST has been under review since October 2020.
- (Date of 9-page letter).*
The NCD was opened on March 1 with a pre-decisional opportunity for public comment on the request letter.
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The initial version of this blog was incorrect and stated there wasn't a pre-decisional public comment.
