10.5 Hearing Technology Goods and Services

DVR purchases hearing aids related to the individual’s medical condition and from the recommendations received from an audiologist, hearing aid provider, or ENT who is appropriately licensed, certified, and/or registered and in good standing with the Office of Audiology Licensure. In addition, the nature and working conditions of the individual’s employment outcome must be considered. Reference CRS 12-5.5-101 and CRS 12-5.5-201.

Hearing assessment includes complete audiological history and full diagnostic evaluation, including pure-tone and bone conduction testing, speech discrimination, tympanometry, acoustic reflex testing, needs assessment, technology evaluation and full report to DVR.

• Hearing Assessment (Procedure code 01700-08) $90.00

This service determines the potential need for hearing aids, including possible assistive technology, and a full written report, including recommendations, to DVR by a provider who meets the criteria as referenced in section 10.5.

• Hearing Aid Evaluation (Procedure code 01750-05) $75.00

(Procedure codes 17500-05, 17500-06)

DVR has entered into contractual relationships with a number of hearing aid manufacturers by participating in a multi-state cooperative agreement administered by the State of Minnesota Cooperative Purchasing Venture (MNCPV). Hearing aid service providers must provide hearing aids under the terms of the Hearing Aid Volume Purchase Contract (HAVPC).

• Pre-authorization is required

• Contract rate is authorized to the hearing aid vendor

• Dispensing Fee is authorized to the hearing aid vendor

• Includes 12 months of loss and damage 

• Includes 24 months of parts and labor

Hearing Aid Volume Purchase Contract Pricing

(Non-HAVPC, procedure code 17500-06)

To purchase hearing aid(s) that are not listed as part of the HAVPC, the service provider must provide DVR the reasons the contract aids will not meet the recipient's needs, and reasons the non-contract aid will meet the recipient's needs.

Exceptions to purchasing hearing aids from the contract include:

• Overall lower cost, including dispensing fee

• No approved vendors to provide services within a geographic area

• No aid available from the contract that will meet an individual’s employment needs

When purchasing hearing aids outside the HAVPC contract, DVR will only pay the price the vendor paid for the non-contract aid (no markup). Appropriate documentation of cost should be submitted when invoicing, including at-cost fee and dispensing fee. Supervisor approval is required for all purchases of non-HAPVC aids unless procuring non-HAPVC aids, including the dispensing fee, is the most cost-effective option for DVR.

(Procedure code 17500-07)

DVR will reimburse the hearing aid service provider one dispensing fee of $700.00 per hearing aid for a recipient after the hearing aid is dispensed.

The dispensing fee includes the following:

• Provision of at least three hearing aid batteries per aid

• Informing the recipient of the trial period

• Instructing and counseling the recipient on use and care of the hearing aid(s)

• Written copy of the manufacturer's warranty (all warranties will be a minimum of 24 months)

• Returning the hearing aid to the manufacturer for repair during the 24-month warranty period for parts and labor

• Routine in-office service for the warranty of the hearing instrument at no additional charge. Includes reprogramming, tube changes, cleanings, instrument checks and in-office repairs.

• Annual Hearing Screening and Check-ups. Complete audio logic history, otoscopic examination of ear canal, threshold testing via insert earphones, and report when requested. No charge for the warranty of the aid(s).

Providers may request authorization for an additional dispensing fee when providing a replacement hearing aid, even if a dispensing fee had been previously paid. For example, an additional dispensing fee may be authorized when hearing aids are replaced under the loss and damage warranty. Additional dispensing fees will not be authorized for replacing an unsatisfactory hearing aid during the required trial period.

Hearing aids that are not satisfactory to the user may be returned to the audiologist within 90 days after the dispensing date. The trial period consists of 90 consecutive days beginning the day the hearing aid is provided to the recipient. If the audiologist prescribes a hearing aid to replace the unsatisfactory aid, the hearing aid service provider (after consultation with the DVR Rehabilitation Counselor) can order the prescribed replacement aid once given authorization.

(Procedure code 17500-01)

Parts include batteries and any other part not included in the original HAVPC contract purchase.

(Procedure code 17500-02, 17500-03,17500-08 )

DVR does not cover repairs or the cost of returning the aid to the manufacturer while the aid is under warranty. To verify the hearing aid warranty has expired, hearing aid service providers must obtain the purchase date and purchase warranty expiration date from the manufacturer and submit this with the hearing aid repair estimate for the pre-authorization of needed repairs. All hearing aid repairs are required to have a minimum 6 months’ warranty, whether sent to the manufacturer or performed by the hearing aid service provider. Most manufacturers on the HAVPC provide a 1-year repair warranty. However, some provide repair warranties as long as 24 months. Providers are responsible to check the manufacturer’s repair warranty information listed on the contract from which the hearing aid was obtained.

NOTE: The hearing aid service provider must inform the recipient of the beginning and ending dates of the trial period, repair warranty, and loss & damage warranty. The hearing aid repair rate is determined by the HAVPC under which the aid was purchased. The HAVPC contract requires manufacturers to honor the contracted repair rate for the life of the hearing aid following the expiration of the contract.

(Procedure codes 17500-02, 17500-03)

Includes assessment of repair need, handling, and all reprogramming and re-fitting

• Hearing Aid, Repair (Out of Warranty) non-HAPC aid: Repair cost plus $50.00

• Hearing Aid, Repair (Out of Warranty) HAPC aid: per HAPC contract plus $50.00

(Procedure code 17500-08)

Replacement of technology including impressions, reprogramming, and re- fitting of replacement products (does not include earmold replacement).DVR pre-authorization or individual-funded;cost variances for replacement aid can cause an increase or decrease over original cost.

(Procedure code 17500-04)

The allowable fee for a cochlear implant device is at the lowest available usual and customary rate. The surgical procedure is priced and authorized separately using appropriate medical restoration procedure codes. For individuals with insurance (e.g., private, Medicaid, or Medicare), the surgery will likely be paid for through these resources.