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Cochlear Implant Reimbursement Support and Resources

Help with billing for providing CI care: in person or remote

Navigating the complexities of insurance reimbursement for cochlear implants can be challenging, especially with the introduction of new ways of providing audiological care, such as the Remote Support app with Target CI. 

We’re here to provide you with resources to help smooth the process so you can focus on what you do best—providing exceptional care.


AB Remote Programming is reimbursable

Whether assessing cochlear implant candidacy, or taking care of your CI patients’ hearing in person or via an AB Remote Programming session, your time and expertise can be eligible for insurance reimbursement. 

Only AB Remote Programming is reimbursable because it meets Medicare’s telehealth reimbursement requirements. 

Specifically, it offers synchronous telemedicine service rendered via a real-time interactive audio and video telecommunication. This allows Remote Programming to be billable with Medicare, unlike competitor solutions.

Our resources can help you find the right code and steps to complete the insurance claims for your services. 

Note: As with all things related to reimbursement, please check with your state board and licensure policies to confirm eligibility. 


Insurance Reimbursement Resources

Insurance Reimbursement Resources



Remote Programming Insurance and Reimbursement FAQ


Only Advanced Bionics offers remote programming that meets the reimbursement criteria for telehealth, including synchronous programming between patient and provider, and live audio-visual support through our programming software.

For an overview of covered Cl services, our Cochlear Implant Coding Quick Reference Guide is attached. Note that how these services are billed depends on who is doing the billing.

Every state manages telehealth coverage differently. For state-specific coverage requirements, consider referring to ASHA's State Specific Telehealth Coverage Guide. This document provides state-specific information as well as external links to state-specific updates.

 

For Medicaid specifics per state, here are the Medicaid Guidelines. For commercial insurance plans, most insurance providers cover at least some form of telehealth service. Your billing department can contact the insurance providers you accept to see if they provide reimbursement for any telehealth services. You can also ask patients to verify their coverage ahead of appointments.

Coverage of telehealth services when they are provided across state lines are at the discretion of your reimbursement/billing department, your state specific licensure, the insurance provider, and the requirements of the state in which services are being provided. 

 

As a first step, meet with your hospital's billing and payment team for guidance regarding telehealth from a hospital specific level. If there is not guidance or protocols in place, state specific requirements can be found here.

Only AB’s Remote Programming solution is real-time, synchronous, has a video and audio interface, and provides full access to our software. As a result, it meets all requirements for full telehealth coverage. 


If you’re learning more about cochlear implants for yourself or a loved one, and you’re looking for more insurance information, our team is standing by to help!