Sometimes it’s unclear whether a part or an accessory you need for your sound processor is covered by your insurance plan. To understand what insurance companies may cover, first we need to understand how insurance companies define what is medically necessary.
Some examples of parts and accessories that are generally covered by insurance are cables, coils, magnets, and rechargeable batteries.
To verify medical necessity, we will request a letter or certificate of medical necessity from your clinician. This documentation typically includes the Healthcare Common Procedure Coding System codes (HCPCS codes) that apply to the specific parts or accessories. Insurance companies use these HCPCS codes to identify if you have coverage for the product or service.
Watch this video to learn more about how medical necessity is defined and how to navigate these definitions when seeking reimbursement for relevant parts and accessories.
Find out more about Reimbursement and Insurance Services and direct insurance billing for parts and accessories here. If you plan on moving forward with a self-pay option and seeking reimbursement on your own, you can read more about that process here.
You can also find a list of HCPCS codes and their descriptions at our insurance support center page. It’s important to check these codes periodically with your insurance company or Cochlear as they are subject to change.
Purchase parts & accessories today at Cochlear’s online store by logging into your Cochlear Family account.1
- Information provided by Cochlear Americas regarding insurance coverage or reimbursement is provided as guidance only and is not intended as reimbursement or legal advice. Cochlear Americas makes no representation or warranty regarding such information or its completeness, accuracy, fitness for a particular purpose, or that following such guidance will result in any form of coverage or reimbursement from any insurer. Information presented is subject to change at any time. To be sure that you have the most current and applicable information available for your unique circumstances, please consult your own experts and seek your own legal advice regarding your reimbursement needs. In all cases, products or services billed must be medically necessary, actually performed and appropriately documented in the medical record.