Cochlear Implants
Medical Policy SUR08 (Cochlear Implant) is effective October 1, 2026. Cochlear implants may be considered medically necessary for bilateral severe to profound pre- or postlingual sensorineural hearing loss, defined as a pure-tone average of 70 dB or greater at 500, 1000 and 2000 Hz, when the individual has limited or no benefit from appropriately fitted hearing aids and the implanted device is FDA approved for the indication and age of the individual. Hybrid cochlear implant/hearing aid systems, cochlear implants for single-sided deafness and asymmetric hearing loss in individuals five years of age or older, and implant replacement may also be considered medically necessary when their criteria are met. Cochlear implantation in individuals younger than 7 months of age is considered not medically necessary.