Service Limitations

(A) The MassHealth agency does not pay for more than one hearing aid per ear per member in a 60-month period without prior authorization in accordance with 130 CMR 416.408. One hearing aid per ear consists of either one binaural hearing-aid fitting, or two monaural hearing aids dispensed more than six months apart, with one aid dispensed for the left ear and the other dispensed for the right ear. (B) Two monaural fittings dispensed within a six-month period, with one aid dispensed for the left ear and the other for the right ear, are defined as a single binaural fitting. The MassHealth agency does not pay two monaural dispensing fees for this service. MassHealth pays only one binaural dispensing fee for this service. (C) The MassHealth agency will pay for the hearing tests listed in Subchapter 6 of the Hearing Instrument Specialist Manual only when provided for the sole purpose of hearing aid fitting and dispensing to an eligible member aged 18 or older. The MassHealth agency will not pay for services for which the provider does not customarily charge non-MassHealth members.