Here are the maximum allowances for medi-cal hearing aid ...



Here are the maximum allowances for medi-cal hearing aid reimbursements:

A) For one (monaural) hearing aid: The one unit wholesale cost plus $256.37 dispensing fee together not to exceed $883.80. In addition to that, the state reimburses the provider for the sale tax paid by the provider to the manufacturer.

B) For two (binaural) hearing aids: The one unit wholesale cost of two hearing aids plus $326.08 dispensing fee together not to exceed $1480.32. In addition to that, the state reimburses the provider for the sale tax paid by the provider to the manufacturer.

For the last several years the state deducts 1% from the total reimbursement. Here is an example reimbursement for binaural set:

- The cost of one hearing aid is: $599X2 = $1,198

- The dispensing fee is: $326.08

- The sale tax charged by the manufacturer is: $78

- The claim submitted to medi-cal will be: $1,198 + $326.08 + $78 = $1,602.08

- Medi-cal will reimburse the following: The maximum allowed for binaural set: ($1,480.32 + $78) X 99% = $1,542.74

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