All PlansCoverageMedium impact
Implantable Bone Conduction Hearing Aids 7.01.77
Excellus BlueCross BlueShield·ENT (Ear, Nose & Throat)·Ear, Nose & Throat (Otorhinolaryngology)
Effective date
Apr 16, 2026
We identified it
Jun 20, 2026
Summary
New medical policy for implantable bone conduction hearing aids establishes specific coverage criteria including age requirements (5+ years), hearing loss thresholds, and qualifying conditions. Policy also covers repair and replacement guidelines for medically necessary devices.
Action Required
By April 16, 2026: ENT billing team must review all bone conduction hearing aid claims against new medical necessity criteria including age requirement (5+ years), speech discrimination scores (60%+ at elevated levels), and qualifying conditions. Update prior authorization processes to verify patients meet all criteria in sections I-II before device implantation. Claims not meeting criteria will be denied.