MedicaidCoverageMedium impact
Coverage Update
Alabama Medicaid·AL · Audiology·Medical Policy
Effective date
Jan 1, 2026
We identified it
Jul 28, 2026
Summary
Alabama Medicaid added coverage for 9 audiology procedure codes (CPT 92631-92639, 92641) effective January 1, 2026, covering hearing aid selection, fitting, post-fitting follow-up, and verification services. Coverage is limited to eligible Medicaid beneficiaries ages 0-20 years, and no prior authorization is required.
Action Required
By December 31, 2025: Billing team must update billing system to recognize CPT codes 92631, 92632, 92634, 92635, 92636, 92637, 92638, 92639, and 92641 as covered services for Alabama Medicaid beneficiaries ages 0-20 only. Configure system to NOT require prior authorization for these codes. Update encounter forms and fee schedules with the specified rates ($32.00, $8.00, $28.00, $7.00, $28.00, $7.00, $17.00, $17.00, $8.00 respectively). Train audiology providers and front desk staff on age eligibility restrictions (0-20 years only) to prevent claim denials. Contact Gainwell Technologies Provider Assistance Center at (800) 688-7989 with any billing questions. Failure to implement these changes may result in claim rejections for out-of-network processing or billing errors.