What is typically covered by insurance
Cochlear’s reimbursement and insurance services provides support and information to help you understand what is typically covered by insurance and payment options.
What you'll find on this page
- Learn what is typically covered by insurance
- Insurance HCPCS codes commonly used for reimbursement of Cochlear products
- Learn how to place an order for new sound processor technology
What is typically covered
Health plans have their own definitions of what is considered Medically Necessary, but typically includes anything that improves your hearing, or is required for the device to function, such as cables, coils, magnets, and rechargeable batteries.
Insurance intake form
Learn what your insurance plan covers.
HCPCS codes
Here is a list of HCPCS codes (Healthcare Common Procedure Coding System) commonly used for Cochlear’s products. Please check with your insurance provider or Cochlear as these codes are subject to change.
HCPCS Codes |
Description |
|
Repair | L7510 | Repair of prosthetic device, repair or replace minor parts |
L7520 | Repair of prosthetic device, labor component, per 15 minutes | |
L8617 | Transmitting coil for use with cochlear implant device, replacement | |
Replacement Parts and Accessories | L8618 | Transmitter cable for use with cochlear implant device or auditory osseointegrated device, replacement |
L9900 or State Misc. Code | Orthotic and prosthetic supply, accessory, and/or service component of another HCPCS "l" code | |
L8617 | Transmitting coil for use with cochlear implant device, replacement | |
L8629 | Transmitting coil and cable, integrated, for use with cochlear implant device, replacement (used for Nucleus 7) | |
Rechargeable Batteries | L8624 | Lithium ion battery for use with cochlear implant or auditory osseointegrated device speech processor, ear level, replacement, each |
Battery Charger | L8625 | External recharging system for battery for use with cochlear implant or auditory osseointegrated device, replacement only, each |
CI Sound Processor Replacement | L8619 | Cochlear implant, external speech processor and controller, integrated system, replacement |
Baha Sound Processor Replacement | L8691 and L8694 or State Misc. Code | Auditory osseointegrated device, external sound processor, excludes transducer/actuator, replacement only, each |
Baha Transducer/Actuator | L8694 | Auditory osseointegrated device, transducer/actuator, replacement only, each |
Baha System Without Osseo | L8692 | Auditory osseointegrated device, external sound processor, used without osseointegration, body worn, includes headband or other means of external attachment; initial purchase must be placed through a clinic |
Billing Support for Parts and Accessories
As of Feb 1, 2018, Cochlear provides direct insurance billing support for many major private insurance plans, Medicare, Medicaid* (including HMOs) and Tricare for repairs, parts and accessories. Cochlear’s full service billing support is available for recipients who are covered under one of the plans with whom Cochlear is contracted. If you would like to place an order for a replacement part or accessory, please keep in mind orders may take up to 2 weeks to process and ship, so please plan ahead.
Please keep in mind that if you choose to self pay for an item generally covered by insurance, you may not be able to submit a claim on your own if Cochlear is contracted with your private insurance provider. Visit www.Cochlear.com/US/InsuranceList to see if Cochlear is contracted with your insurance provider. If Cochlear is contracted with your insurance provider, we suggest placing your order through Cochlear’s Reimbursement and Insurance Services. If you seek reimbursement on your own you will be solely responsible for any amounts to include contractual or discounted payments that your insurance provider does not cover.
*Cochlear is currently enrolled with Medicaid programs in the following states: AZ, CA, CO, CT, DC, FL, GA, IA, ID, IL, IN, KS, KY, LA, MD, ME, MI, MN, MS, MT, NC, ND, NE, NH, NJ, NM, NV, NY, OH, OK, OR, PA, SC, SD, TN, TX, UT, VA, VT, WA, WI, WV, and WY.
Learn how to place a sound processor upgrade order
You can place an order 24 hours a day, 7 days a week on the Cochlear Online Store or call 866-477-0906 to place your order during regular business hours. If you plan to pay using insurance, you will need to provide your insurance information.
Descargo de responsabilidad
Consulte a un profesional de la salud sobre los tratamientos para pérdida de la audición. Los resultados pueden variar, y un profesional de la salud le explicará los factores que podrían afectar el resultado. Lea siempre las instrucciones de uso. No todos los productos están disponibles en todos los países. Comuníquese con su representante local de Cochlear para conocer la información del producto.
Las opiniones expresadas representan el punto de vista de cada individuo. Consulte a su profesional de la salud para saber si reúne las condiciones para el uso de tecnología Cochlear.
ACE, Advance Off-Stylet, AOS, AutoNRT, Autosensitivity, Beam, Button, CareYourWay, Carina, Cochlear, 科利耳, コクレア, Cochlear SoftWear, Codacs, ConnectYourWay, Contour, Contour Advance, Custom Sound, ESPrit, Freedom, Hear now. And always, HearYourWay, Hugfit, Hybrid, Invisible Hearing, Kanso, MET, MicroDrive, MP3000, myCochlear, mySmartSound, NRT, Nucleus, Off-Stylet, Slimline, SmartSound, Softip, Sprint, True Wireless, el logotipo elíptico, WearYourWay y Whisper son marcas comerciales o marcas comerciales registradas de Cochlear Limited. Ardium, Baha, Baha SoftWear, BCDrive, DermaLock, EveryWear, Vistafix y WindShield son marcas comerciales o marcas comerciales registradas de Cochlear Bone Anchored Solutions AB.
Parts and Accessories does not include disposable batteries. While we are happy to provide guidance on insurance coverage about Cochlear's products and technology, please realize that this information is provided as guidance only. Cochlear Americas makes no representation, warranty, or guarantee regarding the fitness for your particular situation of the guidance provided or that following these guidelines will result in any form of coverage or reimbursement. Please be sure to consult with your health care provider to confirm the applicability of our guidance to your particular needs. And remember that all services or products billed to an insurance company or payer must be medically necessary, actually performed or purchased, and appropriately documented.