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AetnaAll Plans · Coverage · Medical Policy · Audiology, Speech Therapy, ENT (Ear, Nose & Throat)Medium impact

Aural Rehabilitation (CPB 0034, reviewed 2026-03-10)

Effective date
Not stated in the notice
Identified
Aug 14, 2026

Summary

Aetna considers aural rehabilitation, including auditory verbal therapy, medically necessary as speech therapy for members with hearing impairments and after placement of a cochlear implant. Aetna considers aural rehabilitation not medically necessary for cochlear implant users who have reached a plateau in performance. Aural rehabilitation is considered experimental, investigational or unproven for individuals with hearing loss who do not have a cochlear implant, and for the treatment of tinnitus. CPT codes 92626, 92627, 92630 and 92633 are covered if selection criteria are met.

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What to do

Action · 4 steps
01Billing team: Before billing CPT 92626, 92627, 92630 or 92633 for aural rehabilitation, confirm the member has a hearing impairment or has had cochlear implant placement, since these codes are covered only if the selection criteria are met.
02Do not bill aural rehabilitation for cochlear implant users who have reached a plateau in performance, because Aetna considers it not medically necessary for them.
03Do not bill aural rehabilitation for hearing loss without a cochlear implant or for tinnitus, because Aetna considers it experimental, investigational or unproven for those conditions.
04For cochlear implant questions, the source points to related CPB 0013 - Cochlear Implants and Auditory Brainstem Implants.

Codes mentioned

9262692627926309263369930Z96.21

Original notice

Aural Rehabilitation (CPB 0034, reviewed 2026-03-10)
aetna.com · Always check the source before changing claims.
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Related policy hubs

Aetna policiesAudiologySpeech TherapyENT (Ear, Nose & Throat)Code 92626Code 92627Code 92630Code 92633Code 69930Code Z96.21

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