AADL Approved Products List – Hearing Aids,
Bone Anchored Hearing Devices and Cochlear Implants
Pricing effective
April
1, 2016
Cost Share Seniors and Adult Dependents of Seniors ... APL H-1
Cost Share Exempt Seniors and Adult Dependents of Seniors ... APL H-3
Cost Share Exempt Adults ... APL H-5
Eligible Full Time Students 18 to 24 Years ... APL H-7
Children Under 18 Years ... APL H-9
Bone Anchored Hearing Devices ... APL H-11
Cochlear Implants ... APL H-12
SCHEDULE A
PAYMENT TERMS
COST SHARE Seniors and Adult Dependents of Seniors
(subject to cost-sharing AADL 75% - Client 25%)
AADL
CAT # DESCRIPTION OF PRODUCT/SERVICE
FREQUENCY
LIMIT PRICE - CANADIAN DOLLARS
H048 Return Fee 1/5 years $150 Cannot be billed if device not trialed 1
H009 H010 H021 H011 H012 H013 H019 H022 H023
High power BTE hearing aid (HFA FOG ≥ 60 dB)
Behind-the-ear hearing aid Receiver In the Canal hearing aid In-the-ear hearing aid
Body type hearing aid Eyeglass type hearing aid Bone conduction hearing aid CROS hearing aid 3
Bi-CROS hearing aid 3
1/5 years $1,200 If Specialty Supplier's advertised
price is less than AADL maximum, advertised price is then cost-shared.2
H024 CROS/Bi-CROS microphone 1/5 years Manufacturer’s invoice cost up to a
maximum of $700. 3
H375 Assistive listening device (may only be substituted for a conventional hearing
aid with AADL Program Manager prior approval) 1/5 years Manufacturer’s invoice cost + $100 for fitting and follow-up services.
H030 H035
Earmold (new or replacement) (not paid with H011)
Service fee for replacement earmold (not within 12 mo. of HA fitting)
1/year 1/year
Manufacturer's invoice cost up to a maximum of $70
$40 4
H051
H072
In-house receiver repair for a Receiver in the Canal (RIC) hearing aid.
Applicable only to aid(s) registered with the AADL program and only after the
original purchase warranty on the receiver has expired.
Service fee for in-house RIC repair only after the original purchase warranty on the receiver has expired.
1/yr
1/yr
Manufacturer's invoice to a maximum of $60
$30 5
H040
H045
Major repair to hearing aids (parts and labour) by manufacturer or qualified repair laboratory. Applicable only to aid(s) registered with the AADL Program
and only after the original purchase warranty has expired.
Service fee for major repair only after one year past the instrument billing date.
1/year
1/year
Manufacturer's invoice to a maximum of $300 6
H055 H056 H057
Replacement bone conduction receivers for bone conduction hearing aids. Applicable only after one year past instrument billing date.
Cords for CROS/Bi-CROS, body type hearing aids (audio input cords excluded) Air conduction receivers for body type hearing aids
1/year 1/year 1/year
Manufacturer's invoice cost up to $100 Manufacturer's invoice cost up to $30 Manufacturer's invoice cost up to $25 1. The Return Fee is a flat rate fee which includes the cost of the assessment, earmold and service fee. No extra billing on fees is
permitted.
2. Flat rate fee includes assessment, cost of instrument and service fee. Clients may choose a higher priced instrument (upgrade) but an appropriate basic entry level technology hearing aid must be offered at the AADL maximum price.
3. H022 (CROS hearing aid) or H023 (Bi-CROS hearing aid) will always be billed in conjunction with a H024 (CROS/Bi-CROS microphone). 4. The service fee of $40 is available to all AADL Clients who are having their earmold replaced after 1 year of use. No extra billing on fees
is permitted.
5. The service fee on repairs is available to all AADL Clients. No extra billing on fees is permitted. Service certificates and manufacturers' invoices must be kept on file. The service fee may be claimed in the final year of a manufacturer's two year warranty. Should the aid require repair in the following year, both the service and repair fees may be claimed regardless of when the repair occurs. Following this, the fees cannot be claimed for twelve months from the date of service. After the fourth year, a six-month warranty is acceptable. This applies to AADL Clients of all ages.
6. CROS/BICROS repairs can bill one major repair fee for the hearing aid/receiver and transmitter to a maximum of $300. CROS/BICROS hearing aid repairs can only bill one service fee to a maximum of $70. Enter one major repair fee and one service fee in E-business with serial numbers in benefit notes.
To calculate the exchange rate on U.S. dollars, use the rate on the first day of the month that the invoice is dated and round it to the nearest .01
•
Please note Seniors and Adult Dependents of Seniors who have maxed out their annual cost-share contribution
PAYMENT TERMS
COST SHARE EXEMPT Seniors and Adult Dependents of Seniors
AADL
CAT # DESCRIPTION OF PRODUCT/SERVICE
FREQUENCY
LIMIT PRICE - CANADIAN DOLLARS
H448 Return Fee 1 per affected
ear/5 years $150 Cannot be billed if device is not trialed
1
H409 H410 H411 H421
High power BTE hearing aid (HFA FOG ≥ 60 dB)
Behind-the-ear hearing aid In-the-ear hearing aid
Receiver In the Canal hearing aid 1 per affected ear/5 years $1200 - maximum per aid, or if Specialty
Supplier's advertised price is less than $1200, advertised price is then billed to AADL.2 H412 H413 H419 H422 H423
Body type hearing aid Eyeglass type hearing aid Bone conduction hearing aid CROS hearing aid 3
Bi-CROS hearing aid 3
1/5 years
H424 CROS/Bi-CROS microphone 1/5 years Manufacturer’s invoice cost up to a maximum of $700 3
H475 Assistive listening device (may only be substituted for a conventional hearing
aid with AADL Program Manager prior approval) 1/5 years Manufacturer’s invoice cost + $100 for fitting and follow-up services.
H430 H435
Earmold (new or replacement) (not paid with H411)
Service fee for replacement earmold (not within 12 mo. of HA fitting)
1/year per ear 1/year per ear
Manufacturer's invoice cost up to a maximum of $70
$40 4
H451
H472
In-house receiver repair for a Receiver in the Canal (RIC) hearing aid.
Applicable only to aid(s) registered with the AADL program and only after the
original purchase warranty on the receiver has expired.
Service fee for in-house RIC repair only after the original purchase warranty on the receiver has expired.
1/year per ear
1/year per ear
Manufacturer's invoice to a maximum of $60 $30 5
H440 Major repair to hearing aids (parts and labour) by manufacturer or qualified repair laboratory. Applicable only to aid(s) registered with the AADL Program
and only after the original purchase warranty has expired.
1/year per ear Manufacturer's invoice to a maximum of $300 6
H445 Service fee for major repair only after one year past the instrument billing date. 1/year per ear $70 5,6
H455 H456 H457
Replacement bone conduction receivers for bone conduction hearing aids. Applicable only after one year past instrument billing date.
Cords for CROS/Bi-CROS, body type hearing aids (audio input cords excluded) Air conduction receivers for body type hearing aids
1/year 1/year 1/year
Manufacturer's invoice cost up to $100 Manufacturer's invoice cost up to $30 Manufacturer's invoice cost up to $25 1. The Return Fee is a flat rate fee which includes the cost of the assessment, earmold and service fee. No extra billing on fees is
permitted.
2. Flat rate fee includes assessment, cost of instrument and service fee. Clients may choose a higher priced instrument (upgrade) but an appropriate basic entry level technology hearing aid must be offered at the AADL maximum price.
3. H022 (CROS hearing aid) or H023 (Bi-CROS hearing aid) will always be billed in conjunction with a H024 (CROS/Bi-CROS microphone). 4. The service fee of $40 is available to all AADL Clients who are having their earmold replaced after 1 year of use. No extra billing on fees
is permitted.
5. The service fee on repairs is available to all AADL Clients. No extra billing on fees is permitted. Service certificates and manufacturers' invoices must be kept on file. The service fee may be claimed in the final year of a manufacturer's two year warranty. Should the aid require repair in the following year, both the service and repair fees may be claimed regardless of when the repair occurs. Following this, the fees cannot be claimed for twelve months from the date of service. After the fourth year, a six-month warranty is acceptable. This applies to AADL Clients of all ages.
6. CROS/BICROS repairs can bill one major repair fee for the hearing aid/receiver and transmitter to a maximum of $300. CROS/BICROS hearing aid repairs can only bill one service fee to a maximum of $70. Enter one major repair fee and one service fee in E-business with serial numbers in benefit notes.
To calculate the exchange rate on U.S. dollars, use the rate on the first day of the month that the invoice is dated and round it to the nearest .01
PAYMENT TERMS
COST SHARE EXEMPT Adults *(18 to 64) covered by the AADL Program
AADL
CAT # DESCRIPTION OF PRODUCT/SERVICE
FREQUENCY
LIMIT PRICE – CANADIAN DOLLARS
H748 Return Fee 1per affected
ear/5 years $150 –returned Cannot be billed unless device trialed and 1
H709 H710 H711 H721
High power BTE hearing aid (HFA FOG ≥ 60 dB)
Behind-the-ear hearing aid In-the-ear hearing aid
Receiver In the Canal hearing aid
1per affected ear/5 years
$1,200 maximum per aid, or if Specialty Supplier's advertised price is less than $1,200 advertised price is then billed to AADL.2 H712 H713 H719 H722 H723
Body type hearing aid Eyeglass type hearing aid Bone conduction hearing aid CROS hearing aid 3
Bi-CROS hearing aid 3
1/5 years
H724 CROS/Bi-CROS microphone 1/5 years Manufacturer’s invoice cost up to maximum of $700 3
H775 Assistive listening device (may only be substituted for a conventional hearing
aid with AADL Program Manager prior approval) 1/5 years Manufacturer’s invoice cost + $100 for fitting and follow-up services.
H730 H735
Earmold (new or replacement) (not paid with H711)
Service fee for replacement earmold (not within 12 mo. of HA fitting)
1/year per ear 1/year per ear
Manufacturer's invoice cost up to a maximum of $70
$40 4
H751
H772
In-house receiver repair for a Receiver in the Canal (RIC) hearing aid.
Applicable only to aid(s) registered with the AADL program and only after the
original purchase warranty on the receiver has expired.
Service fee for in-house RIC repair only after the original purchase warranty on the receiver has expired.
1/year per ear
1/year per ear
Manufacturer's invoice to a maximum of $60
$30 5
H740 Major repair to hearing aids (parts and labour) by manufacturer or qualified repair laboratory. Applicable only to aid(s) registered with the AADL Program
1/year per ear Manufacturer's invoice to a maximum of
H745
and only after the original purchase warranty has expired.
Service fee for major repair only after one year past the instrument billing date. 1/year per ear $70 5,6
H755 H756 H757
Replacement bone conduction receivers for bone conduction hearing aids. Applicable only after one year past instrument billing date.
Cords for CROS/Bi-CROS, body type hearing aids (audio input cords excluded) Air conduction receivers for body type hearing aids
1/year 1/year 1/year
Manufacturer's invoice cost up to $100 Manufacturer's invoice cost up to $30 Manufacturer's invoice cost up to $25 1. The Return Fee is a flat rate fee which includes the cost of the assessment, earmold and service fee. No extra billing on fees is
permitted.
2. Flat rate fee includes assessment, cost of instrument and service fee. Clients may choose a higher priced instrument (upgrade) but an appropriate basic entry level technology hearing aid must be offered at the AADL maximum price.
3. H022 (CROS hearing aid) or H023 (Bi-CROS hearing aid) will always be billed in conjunction with a H024 (CROS/Bi-CROS microphone). 4. The service fee of $40 is available to all AADL Clients who are having their earmold replaced after 1 year of use. No extra billing on fees
is permitted.
5. The service fee on repairs is available to all AADL Clients. No extra billing on fees is permitted. Service certificates and manufacturers' invoices must be kept on file. The service fee may be claimed in the final year of a manufacturer's two year warranty. Should the aid require repair in the following year, both the service and repair fees may be claimed regardless of when the repair occurs. Following this, the fees cannot be claimed for twelve months from the date of service. After the fourth year, a six-month warranty is acceptable. This applies to AADL Clients of all ages.
6. CROS/BICROS repairs can bill one major repair fee for the hearing aid/receiver and transmitter to a maximum of $300. CROS/BICROS hearing aid repairs can only bill one service fee to a maximum of $70. Enter one major repair fee and one service fee in E-business with serial numbers in benefit notes.
To calculate the exchange rate on U.S. dollars, use the rate on the first day of the month that the invoice is dated and round it to the nearest .01
*Cost-share exempt adults (18-64) include clients on AISH and EI programs, and clients who qualify for cost-share
exemption based on AADL’s cost-share policy income thresholds.
*Cost-share adults (18-64) who have maxed out their annual cost-share contribution of $500, through the receipt of
other AADL benefits are not eligible for hearing aid benefits.
PAYMENT TERMS
Eligible Full Time Students 18 to 24 Years (subject to cost-sharing AADL 75% - Client 25%)
AADL
CAT # DESCRIPTION OF PRODUCT/SERVICE
FREQUENCY
LIMIT PRICE - CANADIAN DOLLARS
H714
H748 Hearing Assessment (only billed with hearing aid) Return Fee (cannot be billed unless device trialed and returned) 1/5 years 1 per affected ear/5 years $75 (AHS sites cannot bill) $150 1
H709 H710 H711 H721
High power BTE hearing aid (HFA FOG ≥ 60 dB) Behind-the-ear hearing aid
In-the-ear hearing aid
Receiver In the Canal hearing aid 1 per affected ear/5 years
Manufacturer's unit invoice cost up to $650 H712
H713 H719 H722 H723
Body type hearing aid Eyeglass type hearing aid Bone conduction hearing aid CROS hearing aid 2
Bi-CROS hearing aid 2
1/5 years
H724 CROS/Bi-CROS microphone 1/5 years Manufacturer’s invoice cost up to a maximum of $700 2
H715 General Service Fee 1/5 years $600
H720 Service Fee for Second Aid of a Binaural Fitting (not paid with H722, H723) 1/5 years $600
H730 H735
Earmold (new or replacement) (not paid with H711)
Service fee for replacement earmold (not within 12 mo. of HA fitting)
1/year per ear 1/year per ear
Manufacturer's invoice cost up to a maximum of $70
$40 3
H751
H772
In-house receiver repair for a Receiver in the Canal (RIC) hearing aid. Applicable only to aid(s) registered with the AADL program and only after
the original purchase warranty on the receiver has expired.
Service fee for in-house RIC repair only after the original purchase warranty on the receiver has expired.
1/year per ear
1/year per ear
Manufacturer's invoice to a maximum of $60
$30 4
H740 Major repair to hearing aids (parts and labour) by manufacturer or qualified repair laboratory. Applicable only to aid(s) registered with the AADL
Program and only after original purchase warranty has expired.
AADL
CAT # DESCRIPTION OF PRODUCT/SERVICE
FREQUENCY
LIMIT PRICE - CANADIAN DOLLARS
H745 Service fee for major repair only after 1 year past the instrument billing date. 1/year/per aid $70 4,5
H755 H756 H757
Replacement bone conduction receivers for bone conduction hearing aids. Applicable only after one year from instrument billing date.
Cords for CROS/Bi-CROS, body type hearing aid (audio input cords excluded) Air conduction receivers for body type hearing aids
1/year 1/year 1/year
Manufacturer's invoice cost up to $100 Manufacturer's invoice cost up to $30 Manufacturer's invoice cost up to $25 H700
H725 H705 H750 H760
Frequency Modulation (FM) or Digital Modulation (DM) System FM/DM Fitting Fee
Major Repair to FM/DM (Same conditions as H740)
Service Fee for major FM/DM repairs (Same conditions as H745) FM/DM Return Fee (cannot be billed unless device trialed and returned)
1/5 years 1/5 years
1/yr per component to maximum of 3/year 1/yr per component to maximum of 3/year 1/5 years
Manufacturer's invoice cost up to $1,900 $450
Manufacturer's invoice to a max. of $300 $70
$75
1. The Return Fee is a flat rate fee which includes the cost of the assessment, earmold and service fee. No extra billing on fees is permitted.
2. H722 (CROS hearing aid) or H723 (Bi-CROS hearing aid) will always be billed in conjunction with H724 (CROS/Bi-CROS microphone). 3. The service fee of $40 is available to all AADL Clients who are having their earmold replaced after 1 year of use. No extra billing on fees
is permitted.
4. The service fee on repairs is available to all AADL Clients. No extra billing on fees is permitted. Service certificates and manufacturers' invoices must be kept on file. The service fee may be claimed in the final year of a manufacturer's two year warranty. Should the aid require repair in the following year, both the service and repair fees may be claimed regardless of when the repair occurs. Following this, the fees cannot be claimed for twelve months from the date of service. After the fourth year, a six-month warranty is acceptable. This applies to AADL Clients of all ages.
5. CROS/BICROS repairs can bill one major repair fee for the hearing aid/receiver and transmitter to a maximum of $300. CROS/BICROS hearing aid repairs can only bill one service fee to a maximum of $70. Enter one major repair fee and one service fee in E-business with serial numbers in benefit notes.
To calculate the exchange rate on U.S. dollars, use the rate on the first day of the month that the invoice is dated and round it to the nearest .01
PAYMENT TERMS
Children under 18 Years (subject to cost-sharing AADL 75% - Client 25%)
AADL
CAT # DESCRIPTION OF PRODUCT/SERVICE
FREQUENCY
LIMIT PRICE - CANADIAN DOLLARS
H108
H148 Hearing Assessment (cannot be billed unless device trialed and/or returned) Return Fee (cannot be billed unless device trialed and returned) 1/5 years 1 per affected ear/5 years $75 (AHS sites cannot bill) $150 1
H109 H110 H111 H121
High power BTE hearing aid (HFA FOG ≥ 60 dB) Behind-the-ear hearing aid
In-the-ear hearing aid
Receiver In the Canal hearing aid 2/5 years - binaural
Manufacturer's unit invoice cost up to $650 H112
H113 H119 H122 H123
Body type hearing aid Eyeglass type hearing aid Bone conduction hearing aid CROS hearing aid 2
Bi-CROS hearing aid 2
1/5 years - monaural
H124 CROS/Bi-CROS microphone 1/5 years Manufacturer’s invoice cost up to a maximum of $700 2
H115 General Service Fee 1/5 years $600
H120 Service Fee for Second Aid of a Binaural Fitting (not paid with H122, H123) 1/5 years $600
H126
H128
Earmold (new or replacement) (not paid with H111)
Service fee for replacement earmold (not with a new HA fitting)
1 every 3 months per ear (0-3 yrs of age)
1 every 6 months per ear (4-17 yrs of age)
1 every 3 months per ear (0-3 yrs of age)
1 every 6 months per ear (4-17 yrs of age)
Manufacturer's invoice cost up to $70
$40 3
H151 In-house receiver repair for a Receiver in the Canal (RIC) hearing aid. Applicable only to aid(s) registered with the AADL program and only after
the original purchase warranty on the receiver has expired.
1/year per ear Manufacturer's invoice to a maximum of
AADL
CAT # DESCRIPTION OF PRODUCT/SERVICE
FREQUENCY
LIMIT PRICE - CANADIAN DOLLARS
H172 Service fee for in-house RIC repair only after the original purchase warranty
on the receiver has expired. 1/year per ear $30
4
H140 H145
Major repair to hearing aids (parts and labour) by manufacturer or qualified repair laboratory. Applicable only to aid(s) registered with the AADL
Program and only after original purchase warranty has expired.
Service fee for major repair only after 1 year past the instrument billing date.
1/year/ aid 1/year/ aid
Manufacturer's invoice to a max. of $300 5 $70 4,5
H155 H156 H157
Replacement bone conduction receivers for bone conduction hearing aids. Applicable only after one year from instrument billing date.
Cords for CROS/Bi-CROS, body type hearing aid (audio input cords excluded) Air conduction receivers for body type hearing aids
1/year 1/year 1/year
Manufacturer's invoice cost up to $100 Manufacturer's invoice cost up to $30 Manufacturer's invoice cost up to $25 H500
H515 H550 H555 H560
Frequency Modulation (FM) or Digital Modulation (DM) System FM/DM Fitting Fee
Major Repair to FM/DM (Same conditions as H140)
Service Fee for major FM/DM repairs (Same conditions as H145) FM/DM Return Fee (cannot be billed unless device trialed and returned)
1/5 years 1/5 years
1/yr per component to maximum of 3/year 1/yr per component to maximum of 3/year 1/5 years
Manufacturer's invoice cost up to $1,900 $450
Manufacturer's invoice to a max. of $300 $70
$75
1. The Return Fee is a flat rate fee which includes the cost of the assessment, earmold and service fee. No extra billing on fees is permitted.
2. H722 (CROS hearing aid) or H723 (Bi-CROS hearing aid) will always be billed in conjunction with H724 (CROS/Bi-CROS microphone). 3. The service fee of $40 is available to all AADL Clients who are having their earmold replaced after 1 year of use. No extra billing on fees
is permitted.
4. The service fee on repairs is available to all AADL Clients. No extra billing on fees is permitted. Service certificates and manufacturers' invoices must be kept on file. The service fee may be claimed in the final year of a manufacturer's two year warranty. Should the aid require repair in the following year, both the service and repair fees may be claimed regardless of when the repair occurs. Following this, the fees cannot be claimed for twelve months from the date of service. After the fourth year, a six-month warranty is acceptable. This applies to AADL Clients of all ages.
5. CROS/BICROS repairs can bill one major repair fee for the hearing aid/receiver and transmitter to a maximum of $300. CROS/BICROS hearing aid repairs can only bill one service fee to a maximum of $70. Enter one major repair fee and one service fee in E-business with serial numbers in benefit notes.
SCHEDULE A
BONE ANCHORED HEARING DEVICES
APPROVED PRODUCT LIST
EFFECTIVE JULY 1, 2013
Subject to COST SHARE
AADL
CAT # DESCRIPTION OF PRODUCT/SERVICE
FREQUENCY
LIMIT MANUFACTURER’S MAXIMUM INVOICE COST
H900 Bone Anchored Hearing Device 1/6 years per affected ear $4,100.001,2
H910 Bone Anchored hearing Device Repair 1 per year per affected ear $500.00
1. Bone Anchored Hearing Device with Softband - Maximum AADL funding - $4100 2. Bone Anchored Hearing Device - Maximum AADL funding - $3850
SCHEDULE A
COCHLEAR IMPLANTS
APPROVED PRODUCT LIST
EFFECTIVE JULY 1, 2014
Subject to COST SHARE
AADL
CAT # DESCRIPTION OF PRODUCT/SERVICE
FREQUENCY
LIMIT MANUFACTURER’S MAXIMUM INVOICE COST
H800 Cochlear Implant External Processor 1/7 years per affected ear $10,000.00
H810 Cochlear Implant Repairs 1 per year per affected ear $2,000.00
