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.
Get alerts when payers change rules like this one
We check Alabama Medicaid and other payers every day and email you when a change matches your specialty and state.
Get Alabama Medicaid alertsPolicy Monitoring is free. No card required.
What to do
by Dec 31, 2025 · 5 steps
01Billing 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.
02Configure system to NOT require prior authorization for these codes.
03Update 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).
04Train audiology providers and front desk staff on age eligibility restrictions (0-20 years only) to prevent claim denials.
05Contact Gainwell Technologies Provider Assistance Center at (800) 688-7989 with any billing questions.
If missed: Failure to implement these changes may result in claim rejections for out-of-network processing or billing errors.
Codes mentioned
926319263292634926359263692637926389263992641
Original notice
Coverage Update
medicaid.alabama.gov · Always check the source before changing claims.