Code of Maryland Regulations
Title 10 - MARYLAND DEPARTMENT OF HEALTH
Part 2
Subtitle 09 - MEDICAL CARE PROGRAMS
Chapter 10.09.51 - Audiology Services
Section 10.09.51.06 - Preauthorization Requirements
Universal Citation: MD Code Reg 10.09.51.06
Current through Register Vol. 51, No. 19, September 20, 2024
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 de signee 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, coch lear implants, or auditory osseointegrated devices within 6
months of the preauthorization request.
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