On December 20, 2024, President Biden signed into law the American Relief Act (H.R. 10545). A three-month extension of the current Medicare telehealth services is included within this law.
Additional details regarding telehealth services:
Cochlear™ Nucleus® Remote Assist*:
Audiologists may continue to offer remote care services within the Medicare telehealth services code set. Under this extension, Medicare beneficiaries have continued access to remote programming services (i.e., CPT® 92601-92604).
Cochlear Remote Assist Baha® 6 Max Sound Processor:
Bone conduction programming services were not part of the original telehealth code set; therefore, Remote Assist for Baha Systems will remain as a non-covered Medicare telehealth benefit†.
Remote Check*:
There is no change in coverage for Remote Check services, which are non-covered under Medicare telehealth services due to its asynchronous nature. Practices may consider accepting private payment from Medicare patients in accordance with Medicare requirements.
Need additional information?
- Coding Hotline at (800) 587-6910 or codingsupport@cochlear.com
- Reimbursement Resource Hub: The Hub is designed to give customers direct access to reimbursement resources, including CPT code information, reimbursement overviews and considerations, as well as FAQs.
- Market Access & Payer Strategy Managers: To identify your specific MAPS manager, please check here.
- Additional resources and updates from professional societies advocating for a permanent telehealth: AAA, ADA, and ASHA.
* Remote Check and Remote Assist are compatible with the Nucleus 7 and Kanso 2 sound processors. Remote Check and Remote Assist are intended for ages 6 and older. Remote Check and Remote Assist features are only visible and accessible if they are enabled by a clinician. Clinicians should consider the suitability of the feature before enabling Remote Check and Remote Assist. Remote Check does not replace clinical care and does not involve remote programming of the sound processor. Only available at clinics that have enrolled in Remote Care. For sound processor and app compatibility information visit www.cochlear.com/compatibility
† Practices should be aware of how to implement financial liability notices for non-covered services by using Advanced Beneficiary Notice (ABNs) or waivers. If a patient’s health benefits do not include coverage of a remote care service, a private-pay arrangement may be an option so long as this is not prohibited by the patient’s plan. Patients should be informed in writing of their financial liability using waivers. For more information on ABN administration, please reference MLN006266 Medicare Advance Written Notices of Non-coverage.
CPT and CPT material are copyrights of American Medical Association (AMA): CPT copyright 2024 American Medical Association, all rights reserved. CPT is a registered trademark of the American Medical Association. The information provided in this document is provided as guidelines only to address the unique nature of implantable hearing solutions technology. This information does not constitute reimbursement or legal advice. Cochlear Americas makes no representation or warranty regarding this information or its completeness, accuracy, fitness for any purpose, timeliness, or that following these guidelines will result in any form of coverage or reimbursement from any insurance company or federal health care program payer. The information presented herein is subject to change at any time. This information cannot and does not contemplate all situations that a health care professional may encounter.
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 and coding needs and the proper implementation of these guidelines. All products should be used according to their labeling. In all cases, services billed must be medically necessary, actually performed, and appropriately documented in the medical record.
The purpose of this document is to provide coding options for cochlear implants however, you should always check your payer for specific coding policies to ensure compliance.
