10A NCAC 22G .0509. REIMBURSEMENT PRINCIPLES, HEARING AIDS/ACCESSORIES/BATTERIES

(a)  Payment for hearing aids and accessories, earmolds, repairs, loaner and rental aids are reimbursed at invoice cost.

(b)  Payment for fitting and dispensing services is based on the lower of:

(1)           The provider's actual (submitted) charge, or

(2)           A fixed reimbursement fee based on estimated average statewide fees.  The estimated average statewide fees are determined based on surveys of actual fees charged by providers in the State.

(c)  Payment for batteries used with hearing aids are limited to six claims per year per recipient.  Each claim is reimbursed at the lower of:

(1)           The provider's actual (submitted) charge, or

(2)           A maximum payment amount per claim based on estimates of average usual and customary retail charges as determined based on surveys of retail prices of batteries for hearing aids.

(d)  A dispensing fee for batteries is not allowed.

 

History Note:        Authority G.S. 108A-25(b); 108A-54;

Eff. January 4, 1993;

Recodified from 10 NCAC 26H .0509 Eff. January 1, 1994.