Does Medicaid Cover a Hearing Test? The Federal Child Rule and Two State Examples

The federal child benefit: screening, testing and treatment

Every state Medicaid program runs the Early and Periodic Screening, Diagnostic and Treatment benefit, EPSDT, for enrolled children under age 21. The boundary is under 21, not through 21: coverage under this benefit ends before the 21st birthday.

Medicaid.gov breaks the benefit into steps that map onto a hearing check:

• Screening: hearing is one of the screening tests named, next to vision, dental and developmental checks.
• Diagnostic: further testing to follow up when a risk is identified.
• Treatment: at a minimum, hearing services include treatment for defects in hearing, with hearing aids named as an example.

There is no single national schedule for when a child is screened. Medicaid.gov says states must consult with recognized medical organizations involved in child health care in developing their schedules, or may elect a nationally recognized pediatric periodicity schedule. Between scheduled visits, its vision and hearing screening page says children are entitled to “interperiodic” screenings whenever a provider, a parent, or a health, developmental, or educational professional suspects a possible problem.

Adults: each state writes its own rule, as Alabama shows

Outside EPSDT, a hearing test for an adult on Medicaid depends on the state plan. Alabama Medicaid's hearing services page is direct about it: "Hearing services or hearing aids are not covered for adults."

That sentence covers one state. It does not show what any other state does, and it is no evidence of a shared national adult rule.

The same Alabama page describes child hearing services with its own age wording. Where that wording and the federal phrase differ, the federal EPSDT boundary of under 21 applies to the child benefit, and Alabama's provider manual (Chapter 10, Audiology/Hearing Services) is the reference for exact ages and frequency.

Washington: where audiology coverage is written down

Washington's Apple Health Hearing Services Billing Guide, effective July 1, 2026, shows how a state can split the question. Its audiology coverage section does not list tests itself: it sends the reader to the Physician-Related/Professional Services Fee Schedule for covered services. A separate audiology billing section gives instructions that audiologists must follow on claims, including a billing modifier.

For someone in Washington, the practical consequence is that the hearing services guide alone does not answer whether a given test is covered. The professional fee schedule does, code by code. The guide also keeps child coverage in its own section, so a parent and an adult enrollee may need different pages of the same manual.

What we cannot show yet: Medicaid payments for hearing tests

This site's Medicaid claim series covers hearing aid codes (the HCPCS V5 series), not the procedure codes audiologists use to bill hearing tests. We therefore publish no Medicaid payment amount for a hearing test on this page. A Medicare fee schedule amount is not a Medicaid payment and is not used in its place.

Checking your own state

Three documents answer most of the question for a given state:

1. The state Medicaid agency's hearing or audiology page, which says whether adults are covered at all.
2. The provider billing guide or fee schedule, which lists the covered test codes.
3. The member handbook of your managed care plan, if you are enrolled in one, which sets referral and network rules.

When you book, ask whether the audiologist is enrolled with your state Medicaid program or plan, and whether a referral is needed for a diagnostic test.

Related pages

Hearing aid rules by state are on does Medicaid cover hearing aids. Low-cost and no-cost screening routes outside Medicaid are on free hearing test, and who pays for a child's devices is on hearing aids for children.