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24.3.9 Cochlear Implants
Cochlear implants and aural rehabilitation are benefits for CSHCN Services Program clients who meet the following criteria:
• The client has a profound, bilateral sensorineural hearing loss for cochlear implant.
•The client requesting the cochlear implant has had limited or no benefit from a trial with appropriately fitted hearing aids. A trial of 3-6 months is required for clients without previous experience with hearing aids unless there is a documented reason that hearing aids will not work for that particular client.
•The client is 12 months of age or older.
•The client has the cognitive ability to use auditory cues.
•The client and/or parents are willing and able to comply with aural rehabilitation.
•The client is assessed by both an audiologist and an otolaryngologist experienced in cochlear implants or auditory brainstem implant (ABI) implantation who indicate that the client is a good candidate for the procedure.
Cochlear implants are not considered for reimbursement when one or more of the following situations exist:
•The client has an active ear infection.
•The client is deaf due to lesions of the acoustic nerve or central auditory pathways.
•There is radiological documentation of absent cochlear development.
Cochlear implants or ABI are not considered for reimbursement when the client or the client's parents lack the cognitive ability or willingness to complete aural rehabilitation.
The device must be approved by the Food and Drug Administration (FDA) and must be age-appropriate for the client.
The device and separate components include the cochlear device itself, headpiece/headset, microphone, transmitting coil, transmitter cable, external speech processor, zinc air batteries, alkaline AA batteries, recharger units, and rechargeable AA batteries. A total of 12 replacement rechargeable AA batteries are benefits per year. Up to a maximum of 15 Zinc Air or a maximum of 31 alkaline batteries per month are benefits.
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