MedicaidCoverageMedium impact
MMP 23-07: Cochlear Implant Policy Updates
Michigan Medicaid - MDHHS·MI · Audiology, ENT (Ear, Nose & Throat)·Medical Policy
Effective date
Apr 1, 2023
We identified it
Jun 20, 2026
Summary
Michigan Medicaid expanded cochlear implant coverage to include beneficiaries aged 5+ with single-sided deafness, unilateral hearing loss, or asymmetric hearing loss, with specific audiological criteria that must be met. Prior authorization is still required using form MSA-1653-B with detailed documentation of hearing tests and device trials.
Action Required
Before April 1, 2023: Billing team must update prior authorization processes for cochlear implants to include new coverage criteria for single-sided deafness and asymmetric hearing loss patients aged 5+. Ensure providers document required audiological testing (PTA thresholds, CNC word tests, hearing aid trials) and submit MSA-1653-B forms with complete documentation. Update encounter forms to capture new eligibility criteria including contralateral ear hearing levels and device trial periods.