Thursday, July 7, 2022

NCD Watch: CMS Opens NCD on Cochlear Implants

 CMS has confusing benefits for hearing loss.   CMS by law does not cover "hearing aids" for deafness.  However, some years ago, CMS ruled that a cochlear implant falls outside the definition of hearing aid.   (Apparently, the deceased originalists who wrote the Medicare statute in 1965 would have taken that meaning.)

Anyway, CMS does have a benefit, under an NCD, for cochlear implants.   CMS is considering whether to make the benefit more liberal.   CMS has published a public request to do so.  Right now, CMS covers cochlear implants when hearing scores are <40% (but can cover 40-60% patients under clinical trials).  CMS would raise the regular eligibility requirement from 40% of hearing to 60% of hearing.

  • See the CMS website for NCD activities under current public comment here.
    • Note that public comment regarding whether to revise amyloid PET scan benefits is open, until July 15.
  • See the proposed decision memo for cochlear implants (CAG 00107R) here.
    • Public comment is open for 30 days.
    • See the 9-page letter request here.
  • Note that WHETHER TO ACCEPT THE REQUEST has been under review since October 2020.
    • (Date of 9-page letter).* 

The NCD was opened on March 1 with a pre-decisional opportunity for public comment on the request letter.


The initial version of this blog was incorrect and stated there wasn't a pre-decisional public comment.