Air Conduction Hearing Aids - MEDICAID - SOUTH CAROLINA

This policy covers air-conduction hearing aids — specifically binaural contralateral routing system (CROS/BiCROS) configurations (HCPCS V5211–V5221) — for patients needing pediatric amplification or with adult/age-related, sudden, conductive, sensorineural, or mixed hearing loss, including unilateral severe-to-profound/unaidable ear cases. Coverage is limited to the listed HCPCS codes and requires specified diagnostic testing (pure-tone air and bone conduction, Weber/Rinne), a documented physical exam including pneumoscopy, audiogram thresholds (≥10 dB over 2–3 frequencies) and fulfillment of all eligibility criteria; auditory rehabilitation (CPT 92630/92633) is not covered.

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