Summary
Michigan Medicaid updated reimbursement rates for cochlear implants and bone-anchored hearing devices (BAHDs) to 80% of Medicare rates, established a fee schedule for non-implantable BAHDs (L8692), and expanded coverage to include bilateral BAHD devices. Prior authorization requirements were also updated for bilateral implants and non-surgical devices.
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What to do
by Jan 1, 2019 · 4 steps
01Billing team must update reimbursement calculations for cochlear implant and BAHD supplies to 80% of Medicare DME rates.
02Update billing system to use established fee schedule for CPT code L8692 (non-implantable BAHD) instead of manual pricing.
03Ensure prior authorization is obtained for all bilateral BAHD implantations and non-surgical BAHDs.
04Review current BAHD cases to identify patients who may now qualify for bilateral coverage under expanded criteria.
Codes mentioned
L8692
Original notice
MSA 18-46
michigan.gov · Always check the source before changing claims.