Does Medicaid Cover Hearing Aids? The Child Rule and 11 State Adult Rules

Children under 21: hearing aids are in the federal minimum

Medicaid's EPSDT benefit covers children under age 21 who are enrolled in Medicaid. Medicaid.gov writes that, at a minimum, its hearing services include screening, diagnostic and treatment services for hearing defects, and it names hearing aids among the treatments. The benefit still runs through each state's procedures and medical-necessity rules.

State texts show the split by age. Alabama limits audiological function tests and hearing aids to people eligible for treatment under EPSDT. Indiana caps replacement aids at once every five years, but providers can obtain prior authorization for more frequent replacements for members under 21 when they document the need.

For other ways to pay for a child's aids, see our page on free hearing aids.

Adults: three states, three different answers

The EPSDT text covers children under 21; adult rules come from each state's own regulation or manual. Three current state texts show how far apart they are.

Washington: a written adult benefit with a hearing threshold

Washington's rule covers one new nonrefurbished monaural hearing aid, ear mold included, every five years for clients age twenty-one and older. The client must have an average decibel loss of forty-five or greater in the better ear, based on a pure-tone evaluation by a licensed audiologist or a licensed hearing aid specialist.

Missouri: adults added by category of assistance

A Missouri bulletin dated September 23, 2025 extends hearing aids and related services to adults in listed categories of assistance, for dates of service on or after August 28, 2025. The list includes Old Age Assistance, Permanently and Totally Disabled, MO HealthNet for Families - Adult and Supplemental Nursing Care; the bulletin does not extend coverage to every adult category. Program limitations, requirements and reimbursement stay those of the Hearing Aid Manual. The bulletin applies to the MO HealthNet fee-for-service program and may apply to its managed care program as well.

Alabama: hearing aids kept for EPSDT

Alabama's hearing services chapter, amended with effect from September 14, 2026, limits hearing aids to people eligible for treatment under EPSDT, the child benefit. The aids are provided through hearing aid dealers contracted to the Alabama Medicaid Hearing Aid Program.

The table above lists eleven states with the adult rule as written, the replacement interval when one is stated and the nature of each date. It is a researched subset, not a national directory, and it does not decide whether you qualify.

Replacement intervals, as each state writes them

Where a state writes an interval, it comes with conditions. Washington's five years is the period for one new monaural aid. Massachusetts requires prior authorization for more than one hearing aid per ear in a 60-month period, and counts either one binaural fitting, or two monaural aids dispensed more than six months apart, as one aid per ear. Indiana requires prior authorization for every replacement hearing aid and limits replacements to once every five years, with the documented exception for members under 21.

Several manuals in the table state no interval in the passage we read. The table says so instead of filling in a number.

What each date in the table means

A date beside a state rule is not always the day the rule began, so the table keeps the label the source prints.

Policy effective dates: Washington's rule took effect 11/1/19. Alabama's amended chapter was published July 31, 2026 and took effect September 14, 2026. Missouri's adult categories apply to dates of service from August 28, 2025. Indiana's manual states its policies and procedures as of Oct. 1, 2025, in an edition published Feb. 10, 2026.

Page or revision dates only: the Massachusetts regulation carries the transmittal date 01/02/15, and no separate commencement date is stated on it. Three other manuals show only a revision date, an update month or a printed update label. Where no commencement date is stated, the table says so; the date we read a source, October 2026, is never used as an effective date.

What Medicaid paid on hearing aid claim lines, 2018 to 2024

The lower part of the table reads T-MSIS claims from the HHS Medicaid Provider Spending file, for the HCPCS V5 codes used for hearing aids and related services. Each figure is what Medicaid paid on claim lines. It is not a price, not a current fee and not the cost of one device: a line can be an aid, a fitting, batteries or a repair, each billed under its own code.

By year, Medicaid paid $75,790,088.07 on 550,280 claim lines in 2023 and $70,370,705.98 on 356,696 lines in 2024. The 2024 year is preliminary in the source, with fewer lines reported, so the two years cannot be read as a trend. In 2020 the total was $54,739,712.55 on 404,210 lines.

By provider state for 2023-2024, providers in New Jersey were paid $21,635,122.43 on 37,950 lines and providers in Massachusetts $4,172,419.09 on 49,152 lines. Missouri providers show 27 lines with a paid total of zero; the window ends in December 2024, before Missouri's adult categories took effect, so the table cannot show that change. The state is the provider's state in the NPPES registry, not where the patient lives, and the source drops rows with fewer than 12 claim lines or fewer than 12 beneficiaries.

Two CROS codes with their CMS labels

Our archived extract of the CMS October 2026 HCPCS file covers the CROS and BiCROS codes only, so the table labels two codes and leaves the others without a label rather than guessing one.

V5221, described by CMS as "Hearing aid, contralateral routing system, binaural, bte/bte", had $836,205.64 paid on 632 lines in 2023-2024. V5240, "Dispensing fee, contralateral routing system, binaural", had $5,534.10 paid on 12 lines. The labels are current; the payments are older claims, and neither should be read as a 2026 rate.

To check your own state, find its Medicaid hearing aid rule or provider manual and look for the adult categories, the prior authorization conditions and any replacement interval, then ask the dispenser whether it takes part in the state program.