Hearing Aid Fee Schedule Update and Policy Change
Effective January 1, 2010, reimbursement for the fourteen (14) most frequently billed hearing aid device codes will be increased. Additionally, a new policy regarding reimbursement for hearing aid devices will take effect.
Highlights:
- Policy change: Providers must accept the allowed reimbursement as payment in full. Members may not be balance billed.
- Exception: In cases where reimbursement is based on a maximum benefit amount, such as the Maryland mandate for children, providers may balance bill the member up to charge.
- The member continues to be responsible for any applicable deductible, coinsurance or copayment.
- Coding guidelines can be found in the CareFirst General Information Manual (2.1 MB, 40 pgs.)
- These changes are applicable to all CareFirst networks, including CareFirst BlueChoice, Inc. and FEP members.
Providers can obtain additional information regarding codes or fee allowances from their designated Professional Provider Relations Representative or Provider Relations Analyst.
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