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24.3.9.3 Claims Filing and Reimbursement
Cochlear implants or ABIs may be reimbursed at the lower of the billed amount or the amount allowed by the Texas Medicaid Program.
Implantation of the cochlear device is considered for reimbursement when submitted using procedure code 2/F-69930.
ABI is an adaptation of a cochlear implant. It is a benefit of the CSHCN Services Program for clients 12 years of age and older. ABI procedure code 2-S2235 must be submitted with diagnosis code 23772 to be considered for reimbursement.
Diagnostic analysis of the cochlear implant and subsequent programming is considered for reimbursement using procedure codes 1-92601, 1-92602, 1-92603, and 1-92604.
Equipment and non-rechargeable batteries should be submitted for reimbursement using the following procedure codes:
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