Reimbursement for Implant Technologies
AG Bell has taken steps to advocate for increased reimbursement for cochlear implants and bone-anchored implants, including the BAHA system, for children and adults who are covered under Medicare. Access to these technologies is critical for candidates who use listening and spoken language. Advocacy for reimbursement under Medicare is critical for all candidates—both Medicare beneficiaries and those covered under other insurance plans—because Medicare rates and coverage policies often influence insurance coverage by private insurers.
AG Bell recently submitted letters to the Centers for Medicare and Medicaid Services (CMS), which sets payment rates for the procedures. AG Bell commended CMS for its proposed increase for cochlear implants of 6.5%-6.6%, depending on where the procedure is performed. This amount covers the cochlear implant device, the procedure cost as well as other related costs. This increased payment is a step in the right direction, but this increase does not reflect the actual cost of the intervention. For bone-anchored implants, AG Bell advocated to avert a proposed reduction of 3.8%-5.7% in payment for the BAHA system and to review potential inaccuracies in its data on which payment rates are based.