Md. Code Regs. 10.09.51.04

Current through Register Vol. 51, No. 22, November 1, 2024

Section 10.09.51.04 - Covered Services

The Program covers the following medically necessary services:

A. Audiology services, as follows:

(1) For participants who are at risk for or have a hearing impairment, audiology assessments using procedures appropriate for the participant's developmental age and abilities; and

(2) Hearing aid evaluations and routine follow-up for participants with an identified hearing impairment, who currently use or are being considered for hearing aids; and

B. Hearing amplification services, as follows:

(1) Unilateral or bilateral hearing aids which are medically necessary and are:

(a) Not used or rebuilt, and which meet the current standards set forth in 21 CFR §§ 801.420 and 801.421, which are incorporated by reference;

(b) Recommended and fitted by an audiologist in conjunction with written medical clearance from a physician who has performed a medical examination within the past 6 months;

(c) Sold on a 30-day trial basis; and

(d) Fully covered by a manufacturer's warranty for a minimum of 2 years, at no cost to the Program;

(2) Hearing aid accessories and services, as listed below:

(a) Ear molds;

(b) Batteries;

(c) Routine follow-ups and adjustments;

(d) Repairs after all warranties have expired;

(e) Replacement of unilateral or bilateral hearing aids every 5 years when determined to be medically necessary; and

(f) Other hearing aid accessories determined to be medically necessary;

(3) Cochlear implants and related services, as listed below:

(a) Unilateral or bilateral implantation of cochlear implant or implants which are medically necessary including the cost of the device;

(b) Post-operative evaluation and programming of the cochlear implant or implants;

(c) Aural rehabilitation services; and

(d) Repair or replacement of cochlear implant device components subject to the limitations in Regulation .05 of this chapter; and

(4) Auditory osseointegrated device or devices and related services, as listed below:

(a) Unilateral or bilateral implantation of auditory osseointegrated devices which are medically necessary including the cost of the device;

(b) Non-implantable or softband device or devices which are medically necessary;

(c) Evaluation and programming of the auditory osseointegrated device or devices; and

(d) Repair or replacement, or both, of auditory osseointegrated device components subject to the limitations in Regulation .05 of this chapter.

Md. Code Regs. 10.09.51.04

Regulation .04 amended effective April 4, 2011 (38:7 Md. R. 431)
Regulation .04A amended effective January 16, 2006 (33:1 Md. R. 36); amended effective 45:21 Md. R. 973, eff. 10/8/2018; amended effective 45:21 Md. R. 973, eff. 10/22/2018