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MedicaidCoverageMedium impact

Air Conduction Hearing Aids - MEDICAID - SOUTH CAROLINA (New)

Humana·SC · Audiology, ENT (Ear, Nose & Throat)·Medicaid
Effective date
Sep 3, 2025
We identified it
Jun 24, 2026
Days to comply

Summary

Humana has introduced a new Medicaid policy for air conduction hearing aids in South Carolina, establishing specific coverage criteria including required audiological evaluations and testing. The policy excludes coverage for auditory rehabilitation services (codes 92630, 92633) as not medically necessary.

Action Required

Action needed
By September 3, 2025: Billing team must update South Carolina Medicaid hearing aid claims to require comprehensive audiological documentation including pneumoscopy, pure tone testing, air/bone conduction testing, and Weber/Rinne tests before billing V5211-V5221. Stop billing codes 92630 and 92633 for auditory rehabilitation as these are now excluded from coverage. Update encounter forms to remind audiologists of required testing protocols.

Affected Billing Codes

92590
92591
92593
92630
92633
V5211
V5212
V5213
V5214
V5215
V5221