Current through September 2, 2024
Section 16.03.09.745 - AUDIOLOGY SERVICES: PROVIDER REIMBURSEMENT01.Payment Procedures. The following procedures must be followed when billing the Department:a. The Department will only pay the hearing aid provider for an eligible Medicaid participant if a properly completed claim is submitted to the Department within the one (1) year billing limitation.b. Payment will be based upon the Department's fee schedule in accordance with Section 230 of these rules).02.Limitations. The following limitations apply to audiometric services and supplies:a. Hearing aid selection is restricted to the most cost-effective type and model that meets the participant's medical needs.b. Follow-up services are included in the purchase of the hearing aid for the first two (2) years including repair, servicing and refitting of ear molds.c. Providers are required to maintain warranty and insurance information on file on each hearing aid purchased from them by the Department and are responsible for exercising the use of the warranty or insurance during the first year following the purchase of the hearing aid.d. Providers must not bill participants for charges in excess of the fees allowed by the Department for materials and services.Idaho Admin. Code r. 16.03.09.745