N.J. Admin. Code § 10:64-2.5

Current through Register Vol. 57, No. 1, January 6, 2025

Section 10:64-2.5 - Policies on replacement of a hearing aid

(a) The original hearing aid shall be replaced by a provider only under the following conditions:

1. The aid is lost or stolen or broken. There shall be reasonable expectation that a replacement aid is not likely to be lost, stolen or broken;

2. The aid is malfunctioning and the cost of repairing the aid is 50 percent or more of its replacement cost to the Medicaid/NJ FamilyCare program; or

3. The hearing loss for which the original aid was prescribed has changed such that the original aid no longer is appropriate and the examinations prescribed in N.J.A.C. 10:64-2.1(b) have determined that a new aid should be prescribed.

(b) In those situations in which a replacement aid is repeatedly provided and these services do not reflect the normal use of an aid by a beneficiary, the provider shall contact the Medical Assistance Customer Center for consultation.

(c) Reconditioned hearing aids are not eligible for Medicaid/NJ FamilyCare coverage.

N.J. Admin. Code § 10:64-2.5

Amended by R.2001 d.71, effective 3/5/2001.
See: 32 New Jersey Register 3965(a), 33 New Jersey Register 793(a).
In (b), substituted "beneficiary" for "recipient".
Amended by R.2006 d.289, effective 8/21/2006.
See: 38 New Jersey Register 1385(a), 38 New Jersey Register 3304(a).
In the introductory paragraph of (a), substituted "provider" for "dispenser"; in (a)1, substituted "shall" for "must"; and in (b), substituted "provider shall" for "dispenser is required to" and "Medical Assistance Customer Center" for "Medicaid District Office".

Amended by 53 N.J.R. 2222(a), effective 12/20/2021