Figure 1
CROS and BiCROS coverage rules, as published
| Ohio Medicaid policy | CROS/BiCROS technology may be indicated with a documented need in adverse listening environments |
|---|---|
| Selected Quartz employer-group benefit | CROS appears in the covered-style list for the employer-group coverage described |
| Original Medicare baseline | Hearing aids and fitting exams are outside Original Medicare coverage |
- Ohio Administrative Code,codes.ohio.gov/…/rule-5160-10-11
- Quartz,quartzbenefits.com/…/getting-care-hearing…
- CMS / Medicare.gov,medicare.gov/coverage/hearing-aids
Figure 2
What Medicaid paid, by billing code
A claim payment is what Medicaid paid on a line. It is not a retail price.
| V5221 | 836205.64 | 632 | 1323.1101898734178 |
|---|---|---|---|
| V5240 | 5534.1 | 12 | 461.175 |
Figure 3
What Medicaid paid, by provider state
The state is where the provider bills, not where the patient lives.
| CA | V5221 | 1360.6186092715232 | 604 |
|---|---|---|---|
| MN | V5221 | 514 | 28 |
| NJ | V5240 | 461.175 | 12 |
How to read these numbers (2)
- T-MSIS table is 2023–2024, with 2024 preliminary; provider state, not beneficiary state. Suppressed or absent code cells do not prove no coverage. Claim-line payments are not retail prices or allowed tariffs.
- These figures cover only the codes listed in this table. Device, dispensing and other service codes must not be treated as interchangeable devices. The current Ohio policy differs from older child-only texts.
How a coverage rule words CROS and BiCROS
Ohio's Medicaid hearing aid rule, in the Ohio Administrative Code, spells the terms out: a hearing aid "employing contralateral routing of signal (CROS) or binaural contralateral routing of signal (BiCROS)".
The rule does not treat these aids as automatic. It says such an aid "may be indicated if an individual has a documented need for such technology in noisy or otherwise adverse hearing environments." Two conditions follow from that wording: the need has to be documented, and the need it names is about noisy or adverse listening environments.
For a reader in another state, the useful part is the method. Search your plan's certificate, member handbook or state Medicaid manual for the words "contralateral routing" as well as "CROS" and "BiCROS". If none of the three appears, the plan's general hearing aid terms, and any documentation it asks for, are what a claim will be judged on.
One employer plan's covered list, and its limits
Quartz, a health insurer, posts a covered list for its employer-group members. The page states that, for plans that cover hearing aids, Quartz covers the standard technology level of a set of approved manufacturers, and its table lists CROS among the styles, for example in the Phonak row.
The same page narrows its own reach in three ways:
- The plan must cover hearing aids in the first place. The Summary of Benefits and Coverage or the Certificate of Coverage decides that.
- Several product lines are carved out: the State of Wisconsin Group Health Insurance Program, Quartz Medicare Advantage, BadgerCare Plus and commercial group policies issued in Illinois.
- Related costs follow the device: earmolds and fittings are covered only when the hearing aid model is covered.
One insurer's list says nothing about another insurer. It shows the kind of document to ask your own plan for: a named list of covered styles and technology levels.
Original Medicare: the general hearing aid exclusion
Medicare.gov's coverage page states that Medicare does not cover hearing aids or exams for fitting hearing aids, and that the person pays all costs for those non-covered items. The page speaks of hearing aids as one class.
That exclusion is about hearing aids. Implanted and bone-conduction devices are a separate coverage question that this page does not settle, so a person weighing those options should read the coverage rule for that device category rather than this one.
Medicare Advantage plans can file their own hearing aid benefits on top of Original Medicare. Whether a given plan treats a CROS system as one aid, two aids or a separate tier is a question for its Evidence of Coverage.
Medicaid claims under two V5 codes, 2023-2024
The federal Medicaid provider spending file records what Medicaid paid per claim line by HCPCS code. Of the V5 codes whose HCPCS descriptor contains the word "contralateral" in CMS's October 2026 HCPCS file, two have published claim cells over 2023 and 2024:
- V5221 ("Hearing aid, contralateral routing system, binaural, bte/bte"): $836,205.64 paid across 632 claim lines.
- V5240 ("Dispensing fee, contralateral routing system, binaural"): $5,534.10 paid across 12 claim lines.
The table also gives the paid amount per claim line for each code.
Three cautions apply before reading these rows. First, the claims file carries the code, not its description: the descriptors quoted here come from CMS's October 2026 HCPCS file, and a descriptor can change from one HCPCS year to the next, so check the one in force for the claim year. V5240 is a dispensing fee, not a device. Second, the 2024 months are preliminary and may still rise. Third, a claim payment is what Medicaid paid on a line; it is not a retail price.
Where the claim lines were billed
Split by state, the published cells come from three states (V5221: "Hearing aid, contralateral routing system, binaural, bte/bte"; V5240: "Dispensing fee, contralateral routing system, binaural"):
- California: 604 claim lines under V5221.
- Minnesota: 28 claim lines under V5221.
- New Jersey: 12 claim lines under V5240.
The state here is the provider's state in the NPPES registry, not the state where the patient lives. A clinic near a state line can bill for patients from the next state.
A state missing from this list is not a state without coverage. The source withholds small cells, and a state may pay under another code or through managed-care encounters that the file does not break out. The per-line amounts in the table describe each state's own claims and should not be compared as prices.
What to ask a plan before a CROS fitting
A coverage answer for a CROS or BiCROS system depends on plan wording. Before a fitting, it helps to get written answers to these questions:
- Does the certificate or member handbook name CROS, BiCROS or contralateral routing?
- Is a documented need required, as in Ohio's rule, and who must write it?
- Is the system billed as one hearing aid or two, and how does that count against any device limit?
- Are earmolds, fittings and follow-up visits covered only when the device itself is covered, as on the Quartz page?
- Which providers must dispense the device for the benefit to apply?
Frequently asked questions
What is cros?
CROS stands for contralateral routing of signal, and BiCROS for binaural contralateral routing of signal. Those are the terms Ohio's Medicaid rule uses for these hearing aids. This page covers how payers word and pay for them, not how they are fitted.
Does Medicare pay for BiCROS hearing aids?
Original Medicare does not. Its coverage page lists hearing aids and the exams to fit them as not covered, treating hearing aids as one class, so the full cost falls on the person. A Medicare Advantage plan may add a hearing aid benefit; its Evidence of Coverage says whether a BiCROS system qualifies.
Is Medicare going to pay for hearing aids in 2026?
Not under Original Medicare. The Medicare.gov hearing aid page we read in October 2026 still marks hearing aids as not covered and says the person pays all costs. Any hearing aid help for someone on Medicare comes from a Medicare Advantage plan's own benefit, and for a CROS system that benefit's exact wording decides.
Sources
Policy wording is quoted from the Ohio Administrative Code, Quartz's own employer-group page and Medicare.gov, read in October 2026. Claim figures come from the HHS Medicaid provider spending file for 2023-2024, with 2024 preliminary, state taken from the provider's NPPES record. Codes are shown without descriptors; paid amounts are claim payments, not prices.
- https://codes.ohio.gov/ohio-administrative-code/rule-5160-10-11
- https://quartzbenefits.com/members/employer-group-plan-members/employer-group-members-forms-resources/getting-care-hearing-aids/
- https://www.medicare.gov/coverage/hearing-aids
- https://opendata.hhs.gov/datasets/medicaid-provider-spending/
- https://www.cms.gov/files/zip/october-2026-alpha-numeric-hcpcs-file.zip
Cost and coverage research, not medical advice. This page does not decide whether a CROS or BiCROS aid suits you or whether a plan will pay; confirm coverage in your plan documents.