H.R. 5371, also known as the “Continuing Appropriations and Extensions Act of 2026” would have extended telehealth flexibilities through November 21, 2025. Congress was not able to pass this legislation prior to their September 30 deadline, and as a result, telehealth reimbursement for audiologists through the Centers for Medicare and Medicaid Services (CMS) has expired.
Additional details regarding telehealth services:
Remote Assist† for Cochlear™ Nucleus® Sound Processors:
Audiologists may continue to provide telehealth services. However, they will not be eligible for reimbursement for remote care services when provided to Medicare beneficiaries.* Other payers, including commercial and Medicaid insurers may cover telehealth services for remote programming (i.e., CPT® 92601-92604).
Remote Assistⱡ for Cochlear™ Baha® Sound Processors:
Bone conduction programming services were not part of the original telehealth code set; therefore, Remote Assist for Baha systems will remain a non-covered Medicare telehealth benefit.*
Remote Check† for Cochlear Nucleus Sound Processors:
There is no change in coverage for Cochlear Remote Check services, which remain non-covered under Medicare telehealth services due to the asynchronous data exchange.*
Interested in learning more about efforts to make telehealth coverage permanent?
Please visit the following professional society websites:
- Providing Audiology and Speech-Language Pathology Telehealth Services Under Medicare
- Federal Affairs – American Academy of Audiology
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 (MAPS): To identify your specific MAPS manager, please check Here.
† Remote Check for Nucleus sound processors is approved for all ages, however certain tests are not suitable for ages below 6. Remote Check does not replace clinical care and does not involve remote programming of the sound processor. Remote Assist for Nucleus sound processors is approved 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. Only available at clinics that have enrolled in Remote Care.
ⱡ Remote Assist for Baha for compatible Baha sound processors is intended for a follow-up adjustment or setup of a replacement or upgrade sound processor for suitable qualified patients based on clinical judgment. Only available at clinics that have enrolled in Remote Care.
* 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 2025 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.
