Sec. 10.09.51.06. Preauthorization Requirements

A. The Department requires preauthorization for the following services:

(1) All hearing aids;

(2) Certain hearing aid accessories;

(3) All cochlear implant devices and replacement components except microphone, transmitter cables, and transmitting coils;

(4) All auditory osseointegrated devices; and

(5) Repairs for hearing aids, cochlear implants, and auditory osseointegrated components exceeding $500.

B. Preauthorization is valid:

(1) For services rendered or initiated within 6 months from the date the preauthorization was issued; and

(2) If the patient is an eligible participant at the time the service is rendered.

C. The following written documentation shall be submitted by the provider to the Department or its designee with each request or preauthorization of hearing aids, cochlear implants, or auditory osseointegrated devices:

(1) Audiology report documenting medical necessity of the hearing aids, cochlear implants or auditory osseointegrated devices;

(2) Interpretation of the audiogram; and

(3) Medical evaluation by a physician supporting the medical necessity of the initial hearing aids, cochlear implants, or auditory osseointegrated devices within 6 months of the preauthorization request.