Aetna considers aural rehabilitation medically necessary as speech therapy for members with hearing impairments and after placement of a cochlear implant.
See also CPB 0013 - Cochlear Implants and Auditory Brainstem Implants.
An aural rehabilitation program generally starts as soon as a patient is identified as having a hearing impairment, or after placement of a cochlear implant. The patient is taught to speak, to adjust to a hearing aid or cochlear implant, and to look to a speaker's mouth and face to better comprehend what is being said. The parent or other caregiver is taught to treat the patient normally, to talk to the patient, and interact with him/her as though there were no impairment. The rehabilitation program following implantation of a cochlear implant usually consists of 6 to 10 sessions that last approximately 2.5 hours each.
The above policy is based on the following references:
|Information in the [brackets] below has been added for clarification purposes.  Codes requiring a 7th character are represented by "+":
|ICD-10 codes will become effective as of October 1, 2015 :
|CPT codes covered if selection criteria are met:
||Evaluation of auditory rehabilitation status; first hour
|| each additional 15 minutes
||Auditory rehabilitation; pre-lingual hearing loss
|| post-lingual hearing loss
|Other CPT codes related to the CPB:
||Cochlear device implantation, with or without mastoidectomy
|Other HCPCS codes related to the CPB:
|L8614 - L8624
|ICD-10 codes covered if selection criteria are met:
|H74.01 - H74.93
||Other disorders of middle ear mastoid
|H80.00 - H80.93
|H81.01 - H81.09
|H90.0 - H90.8
||Conductive and sensorineural hearing loss
|H93.011 - H93.93
||Other disorders of ear, not elsewhere classified
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- American Speech-Language-Hearing Association (ASHA). Aural rehabilitation. Information for the Public. Rockville, MD: ASHA; 2004. Available at: http://www.asha.org/public/hearing/treatment/gen_aur_rehab.htm. Accessed January 22, 2004.
- Tobey EA, Devous MD Sr, Buckley K, et al. Pharmacological enhancement of aural habilitation in adult cochlear implant users. Ear Hear. 2005;26(4 Suppl):45S-56S.
- Hawkins DB. Effectiveness of counseling-based adult group aural rehabilitation programs: A systematic review of the evidence. J Am Acad Audiol. 2005;16(7):485-493.
- Boothroyd A. Adult aural rehabilitation: What is it and does it work? Trends Amplif. 2007;11(2):63-71.
- Sweetow RW, Sabes JH. Technologic advances in aural rehabilitation: Applications and innovative methods of service delivery. Trends Amplif. 2007;11(2):101-111.
- Li J, Xi X, Hong M, et al. Study of aural rehabilitation in post-lingual deafened patients with multi-channel cochlear implant. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2010;24(13):580-582.
- van Besouw RM, Nicholls DR, Oliver BR, et al. Aural rehabilitation through music workshops for cochlear implant users. J Am Acad Audiol. 2014;25(4):311-323.