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Medicaid Payment and Procedures Policy

Contact: Melysa Johnson
Created: 2026-02-18
Date Emailed to Staff: 2026-02-20
Effective Date: 2026-02-18

Summary of Changes

As of 1/1/26, new CPT codes were issued for hearing aid benefits but Medicaid has not included them in the fee schedule. Until they are added to the fee schedule (estimated date of 7/1/26), authorize at 60% of the submitted charge (quote) if the item is under $1,200 and 70% of the submitted charge (quote) if the item is over $1,200.

Forms - New or Revised

None

QE2 Update

None

To Do

N/A

Team Communication

Fiscal associates should be aware of the policy changes regarding authorizations for the new CPT codes.

VRIS Posting

https://webforms.nebraska.gov/program_manual_chapters/1264

Monitoring Requirements

None

Training Dates

This information was provided to the fiscal associates on 2/12/26.