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MedicaidPrior AuthMedium impact

MSA 20-11

Michigan Medicaid - MDHHS·MI · Audiology, ENT (Ear, Nose & Throat)·Provider Bulletin
Effective date
Jul 1, 2020
We identified it
Jun 20, 2026
Days to comply

Summary

Michigan Medicaid has revised its hearing services policies, eliminating prior authorization requirements for many hearing devices including CROS/BICROS devices and hearing aids for unilateral hearing loss, while expanding coverage for adult bilateral cochlear implants and updating visit limits for auditory rehabilitation and cochlear implant mapping.

Action Required

Action needed
By July 1, 2020: Billing team must update system to remove prior authorization requirements for CROS/BICROS devices and hearing aids for unilateral hearing loss on Michigan Medicaid Volume Purchase Contract. Update auditory rehabilitation billing to use CPT codes 92630 and 92633 with 36-visit annual maximum. Adjust cochlear implant mapping to allow 1 initial plus 5 subsequent sessions per implant. Review bilateral cochlear implant coverage criteria for adults 20+ years old.

Affected Billing Codes

92630
92633
V5266