What is typically covered by insurance

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.

Our team can help you determine if your insurance plan covers:

• Cochlear™ Implants
• Cochlear™ Baha® Systems
• Cochlear™ Wireless Accessories
• Cochlear™ Replacement Parts

Contact us today to learn more about what is typically covered by insurance and how we can help you navigate the insurance process.

HCPCS codes

Here is a list of HCPCS codes (Healthcare Common Procedure Coding System) commonly used for billing Cochlear’s products. You can discuss these with your insurance’s member services for a better understanding of how they are covered by your provider. These codes are subject to change so contact your insurance provider or Cochlear for additional support.

Cochlear Item	HCPCS Codes	Description
Sound Processor Repair	L7510	Repair of prosthetic device, repair or replace minor parts
	L7520	Repair of prosthetic device, labor component, per 15 minutes
Coils and Cables	L8618	Transmitter cable for use with cochlear implant device or auditory osseointegrated (bone conduction) device, replacement
	L8629	Transmitting coil and cable, integrated, for use with cochlear implant device, replacement
Rechargeable Batteries	L8624	Lithium ion battery for use with cochlear implant or auditory osseointegrated (bone conduction) device speech processor, ear level, replacement, each
Battery Charger	L8625	External recharging system for battery for use with cochlear implant or auditory osseointegrated (bone conduction) device, replacement only, each
Miscellaneous Parts and Accessories	L9900 or State Misc. Code	Orthotic and prosthetic supply, accessory, and/or service component of another HCPCS "L" code
CI Sound Processor Replacement (new or same technology)	L8619	Cochlear implant, external speech processor and controller, integrated system, replacement
Baha Sound Processor Replacement (new or same technology)	L8691	Auditory osseointegrated (bone conduction) device, external sound processor, excludes transducer/actuator, replacement only, each
Baha System Without Surgical Implant	L8692	Auditory osseointegrated (bone conduction) device, external sound processor, used without osseointegration, body worn, includes headband or other means of external attachment

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: AL, 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.