Binaural Hearing Aid Billing and Prior Authorization (PA) Form Now Available for Hearing Aid Providers
On December 23, 2025, the Department issued temporary billing guidance for binaural hearing aids effective for dates of service (DOS) November 15, 2025, through June 30, 2026. We are sending this message to remind providers this temporary billing process will end for DOS on or after July 1, 2026.
Effective July 1, 2026, providers should follow routine claims and PA submission processes for coverage of binaural hearing aids in accordance with criteria found in Maine P.L. 2025, Chapter 446 (also known as LD 167) - Act to Provide 2 Hearing Aids to MaineCare Members with Diagnosed Hearing Loss.
Providers may obtain the updated Hearing Aid Prior Authorization Form for claims with DOS on or after July 1, 2026 on the Provider Resources webpage. When the Health PAS Online Portal upgrade is complete, the form will be posted on the new portal.
REMINDER – Billing Members for Non-covered Services
Providers may bill members for non-covered services only when they follow MaineCare Benefits Manual (MBM) Chapter I, Section 1.06-4(A) by:
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Prior to the provision of the service, the provider has clearly explained to the member that MaineCare does not cover the service and that the member will be responsible for the payment
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Documenting in the member’s record the provider told the member, prior to provision, that the service was not a MaineCare covered service and the member is responsible for the payment
For questions, please contact Shannon Beggs, Provider Relations Specialist.