Early Hearing Detection and Intervention Program

Funding

EHDI Initial Hearing Aids

The state-funded Early Hearing Detection and Intervention (EHDI) program provides funding for hearing aids for children ages 0 to 3 who are diagnosed with permanent hearing loss at no cost to the family.

One-time coverage includes a dispensing fee (with an initial supply of batteries), the cost of hearing aids, and earmolds. EHDI funding reimburses using current Medicaid rates.

Eligibility and Pre-Screening

Children eligible for EHDI funding are younger than age 3 with a documented permanent hearing loss in one or both ears, do not have Medicaid, and may have private insurance without a hearing aid benefit. There are no income eligibility or citizenship requirements for inclusion in this program.

When applying for coverage through the EHDI fund using the NCTracks system, all children will automatically be screened through the NCTracks system first to see if they qualify for Medicaid or other payers. EHDI is for children without Medicaid or other insurance.

Coverage

The EHDI Initial Hearing Aid fund can provide coverage up to what Medicaid would pay only. It is the payer of last resort. This means that if an audiology practice chooses to participate in the EHDI Initial Hearing Aid program, they cannot bill the family the difference between Medicaid reimbursement rates and non-Medicaid rates for hearing aids and fitting. Although you may be pre-approved for EHDI funding, it is not a guarantee of payment.

How To Apply

• Complete Form 3014 (DHHS 3014) (PDF, 50 KB)
• Fill out all highlighted sections
• The audiologist signs as the interviewer
• Parents must sign form
• Fax 3014 to the EHDI program at (919) 870-4881
• EHDI program staff will enter child into NC Tracks system. 
• Request Prior Authorization (PA) in the NCTracks system
• Check NCTracks to make sure that child is in the system and eligible for EHDI
• Download Allowable Billing Codes (PDF, 17 KB)
• Make sure that the NPI numbers on the PA match what will be used for billing, or the claim will be denied.
• The requesting audiologist should check NC Tracks periodically for approval status. Once approval has been confirmed, the audiologist can proceed with the hearing aid fitting.
• Request Claim
  • Hearing aids currently can be billed through NCTracks. If there is insurance, an EOB must be received before a claim can be submitted into NCTracks.
  • Make sure that the NPI numbers on the PA match what is used for billing. Otherwise, the claim will be denied.