Hearing aid and audiometric evaluation services for Medicaid clients younger than 21 years of age are reimbursed to willing and qualified Medicaid providers. Audiology and hearing services may be provided in an individual or group setting. Audiology and hearing services must be prescribed by a physician or by another licensed practitioner within the scope of his or her practice under state law.
Methodology / Rules
The Hearing Aid and Audiometric Evaluations program rules are located at Title 1 of the Texas Administrative Code, Part 15, Chapter 354, SubChapter A, Division 15, Rules 1031, 1233 and 1235.
Reimbursement rules applicable to Hearing Aid and Audiometric Evaluations are located at Title 1 of the Texas Administrative Code, Part 15, Chapter 355, SubChapter J, Division 8, Rule 8141.
The fee schedules and any periodic adjustment(s) to the fee schedules are published in banner messages contained in provider Remittance and Status (R&S) reports, Medicaid Bulletin articles, web postings, provider manual, fee schedules or other provider notification.
Payment Rate Information
Payment rate information is published by procedure code in the applicable Texas Medicaid Fee Schedule located on the Texas Medicaid & Healthcare Partnership (TMHP) website (see Fee Schedules).