Coverage Update – Hearing Evaluation

Audiology providers and billing staff should immediately verify that all hearing aid fitting claims include documentation that the supporting hearing evaluation was performed by a licensed physician within six (6) months prior to the fitting date. Update claim submission procedures and internal auditing workflows to enforce this six-month window requirement for Alabama Medicaid claims. Implement a compliance check in the billing system or claim review process to flag any hearing aid fittings where the physician evaluation predates the fitting by more than six months, as these claims will not meet Alabama Medicaid's coverage guidelines and may be denied.