Schedule of Service Items
Schedule of Service Items - Amended 1 November 2020.
Contents
General Program Service Requirements
All services within voucher period
Device quotes for every fitting
Partially subsidised device maintenance co-payment
610 Audiological case management
First Fitting, Follow-up & Maintenance
630 First hearing aid fitting, rehabilitation & maintenance - Monaural
640 First hearing aid fitting, rehabilitation & maintenance - Binaural
650 First hearing aid fitting, rehabilitation - Monaural
660 First hearing aid fitting and rehabilitation - Binaural
635 First fitting, rehabilitation & maintenance –Assistive Listening Device (ALD)*
655 First fitting, rehabilitation - ALD
760 Fitting of a second aid & additional maintenance
770 Fitting of second aid without additional maintenance
Maintenance & Batteries (subsequent years)
700 Maintenance service & battery supply - Monaural
710 Maintenance service & battery Sspply – Binaural
711 Relocated maintenance service & battery supply - Monaural Aid
722 Relocated maintenance service & battery Supply - Binaural Aids
Maintenance for Hearing Aids Fitted Outside the Voucher System
790 Maintenance service & battery supply - Monaural (aid fitted outside Voucher System)
791 Maintenance service & battery supply - Binaural (outside voucher)
Reassessment, Refitting and Review
810 Audiological advice case management - Reassessment
820 Refitting & rehabilitation - Monaural
825 Refitting & rehabilitation – ALD*
830 Refitting & rehabilitation - Binaural
930 Client review – (Monaurally Fitted)
940 Client Review – (Binaurally Fitted)
840 Replacement of Lost or Damaged Beyond Repair (DBR) Hearing Aid – Monaural
850 Replacement of Lost or DBR Hearing Aids - Binaural
888 Payment of Client fee for replacement aid(s) for DVA eligible Clients
555 Payment of Client fee for replacement aid(s) for exempt Clients (other than DVA Clients)
960 Provision of spare hearing aid
The Annual Hearing Aid Maintenance Charge Payable by the Client
The Device Replacement Fee Payable by the Client
Note - Please refer to CSPN Conditions for Claiming - Update and Provider Factsheet Conditions for Claiming - Update of the updated changes to Schedule of Service Items as of 1st November 2020.
General Program Services Requirements
These general program service requirements apply to all relevant program services.
Contracted Service Providers must comply with all General Program Service Requirements.
Definitions used throughout the Schedule of Service Items are as defined by the Hearing Services Administration Act 1997, Hearing Services Program (Voucher) Instrument 2019, and/or Service Provider Contract.
Service Requirements
All Services within voucher period
Except for maintenance services where the client is on a maintenance agreement, the service must be performed within the client’s current voucher start and expiry dates. For maintenance claims, the maintenance agreement must commence between the Client's Voucher start and expiry dates. The client is entitled to maintenance services for 12 months from the date of commencement, even if the client has lost eligibility and no longer has a voucher.
Services within 12 months
Any reassessment, and/or consequent refitting, within 12 months of the original fitting, does not attract a Scheduled Fee but is considered part of the original Hearing Rehabilitation service unless specific approval to claim is given by the Department of Health.
Private Services
Private services can be provided to program clients only if the same or substantially similar service is not available for the client on their current voucher. The contract specifies what information must be maintained by the provider when delivering private services to program clients.
Subcontracting
Providers must not subcontract any hearing services unless for the purposes of obtaining locum support at a site owned/operated by the provider or if permitted under the conditions for claiming in the service item information below.
Device Supply Requirements
Device quotes for every fitting
A quote must be provided for all devices supplied under the program (fully and partially subsidised devices, replacements, spare devices and ALDs). The quote must be given to the client on or before the fitting date. The quote should be signed and dated by the client on the day it is received as evidence it has been provided prior to the fitting. The quote must comply with program requirements as published on the program website.
Only approved devices fitted
The device/s fitted must be listed on a Schedule of Approved Devices on the fitting date, unless otherwise approved by the department, and the correct device code used when claiming. Device/s supplied to program clients and claimed through the program must be purchased directly by the provider from an Appointed Supplier.
Non follow-up fitting claims
Evidence that every reasonable effort has been made to contact the client, including file notes and copies of correspondence, should be kept on the client record. Payment will be a fee equivalent to the cost of the device/s and one half of the fitting item. the date of service must match the date of fitting.
Partially subsidised maintenance co-payment
A Partially Subsidised Device maintenance co-payment above the standard maintenance co-payment may be charged only in relation to a device fitted from the Partially Subsidised Schedule of Approved Devices and must be included in the device quote provided to the client prior to the fitting.
Minor Maintenance
Minor maintenance is not available from 1 October 2019. Providers may still submit claims if the minor maintenance service was completed prior to 1 October 2019.
New Clients
Assessment
600 First assessment
Description of Service Item
The first assessment undertaken by a Qualified Practitioner or Provisional Practitioner under the supervision of a Qualified Practitioner as authorised by a Voucher, or a Letter of Authority.
The range of outcomes covered under this item are described in the Hearing Rehabilitation Outcomes: Outcome 1, Assessment; Outcome 2, Referrals; Outcome 3, Hearing Rehabilitation Program; Outcome 6, Aftercare. (See Glossary for details of specific services).
Conditions for Claiming
The Date of Service is the date of the assessment.
The assessment can be performed by a Qualified Practitioner or Provisional Practitioner under the supervision of a Qualified Practitioner.
This item may be claimed only where the Client has a current Voucher, or a Letter of Authority.
The service must be performed within the Voucher or Letter of Authority start and expiry dates.
The practitioner’s number must be included on the claim form.
The item may be claimed once only for each Client.
Any reassessment, and/or consequent refitting, within 12 months of the original fitting, does not attract a Scheduled Fee but is considered part of the original Hearing Rehabilitation Program unless specific approval to claim is given by the program.
610 Audiological case management
Description of Service Item
Audiological advice which is necessary to provide a complete and accurate assessment required to achieve the Hearing Rehabilitation Outcomes: Outcome 1, Assessment; Outcome 2, Referrals. (See Glossary for details of specific services).
This item is subsequent to a First Assessment and services may be performed only by a Qualified Practitioner (Audiologist). The service consists of advice to a Qualified Practitioner (Audiometrist) to enable the completion of the Audiometrist’s assessment of a non-routine Client, required to achieve the Hearing Rehabilitation Outcomes: Outcome 1, Assessment and Outcome 2, Referrals.
Conditions for Claiming
This item can be claimed where the Client has a Voucher or Letter of Authority. The service must be performed within the Voucher or Letter of Authority start and expiry dates.
This item may be claimed where: a Client's assessment results have been referred to a Qualified Practitioner (Audiologist) by a Qualified Practitioner (Audiometrist) for audiological advice, required to achieve the Hearing Rehabilitation Outcomes: Outcome 1, Assessment, Outcome 2, Referrals.
This item may be claimed only with a Qualified Practitioner (Audiologist) number.
This item may be subcontracted to a Qualified Practitioner (Audiologist).
The Date of Service is the date that the audiological advice and/or testing is provided.
This item can be claimed only in relation to a 600 item and the Date of Service must be on or after a 600 item.
The item may be claimed once only for each Client.
670 Rehabilitation service
Description of Service Item
This item provides an alternative for Clients who are not to be fitted with a hearing device but who would benefit from receiving training and strategies to manage the effects of their hearing loss. This item is not available to Clients who have been previously fitted with a device. Clients who utilise this item can be subsequently fitted with a device subject to eligibility for a new voucher and where this is determined to be clinically necessary on the basis of a reassessment.
The range of outcomes covered by this item are described in the Hearing Rehabilitation Outcomes: Outcome 3, Hearing Rehabilitation Program and Outcome 6, Aftercare.
Conditions for Claiming
This item can only be claimed after assessment or reassessment, where the Client has a valid voucher. This item cannot be claimed where the Client has been fitted previously.
To claim this item two appointments must take place after the assessment or reassessment appointment.
The first appointment is to provide a rehabilitation service consultation, with a second appointment to provide rehabilitation service follow up. These two appointments should be recorded separately on the claim form, with the rehabilitation follow up appointment date being recorded in the box marked 'For Rehabilitation Item Only - Follow up date'.
The item may be claimed once only for each client.
First Fitting, Follow-up & Maintenance
630 First hearing aid fitting, rehabilitation & maintenance - Monaural
Description of Service Item
This is the first hearing aid fitting where one hearing aid is clinically suitable to the Client's needs. The item includes a full rehabilitation program and hearing aid maintenance and batteries for 12 months from the date of fitting.
The range of services and outcomes covered by this item are described in the Hearing Rehabilitation Outcomes: Outcome 4, Fitting of Hearing Devices; Outcome 5, Follow-up; and Outcome 6, Aftercare.
Only devices on the Schedule of Approved Devices may be fitted.
Conditions for Claiming
This item may be claimed only after a First Assessment or after a reassessment using a Return Voucher if the Client has not been previously fitted. The item may be claimed once only and applies where the Client has agreed to pay the annual hearing aid maintenance charge (unless “exempt”). The Date of Service for this item is the date of the first follow-up after the date of fitting.
A claim cannot be submitted until after the fitting and follow up have occurred.
First follow up should be undertaken not less than one week after the fitting, unless there are extenuating circumstances documented on the Client’s record.
This item is claimed where the Client is fitted monaurally.
The fitting range of the device should accommodate for the expected deterioration in hearing thresholds over the lifespan of the device. Should this condition not be met, providers must outline the justification for fitting the device in the supporting documentation including file notes.
The device fitted must be listed on the Schedule of Approved Devices and the correct device code used when claiming.
Where a 'Partially Subsidised' device is fitted, the Contracted Service Provider is required to indicate, on the claim form, the device equivalent Category (C1, C2 or C3) from which the Client would have been fitted had they not been fitted with a Partially Subsidised Device.
A Partially Subsidised maintenance fee may be charged only in relation to a device fitted from the Partially Subsidised Schedule of Approved Devices.
Where a Behind-the-Ear device is fitted a dispensing fee is added as part of this item.
Variation for Manual Payments
Item 631
Where a follow-up has not occurred or every reasonable effort has been made to arrange the follow-up appointment and the Client will not attend, the claim should be submitted to the Department of Health (the Department) for payment.
Supporting documentation including file notes and copies of correspondence should accompany the manual claim for payment. Where the Department accepts the claim for payment it will attract a fee equivalent to the cost of the device/s and one half of the fitting item.
Any reassessment, and/or consequent refitting, within 12 months of the original fitting, does not attract a Scheduled Fee but is considered part of the original Hearing Rehabilitation Program unless specific approval to claim is given by the Department.
640 First hearing aid fitting, rehabilitation & maintenance - Binaural
Description of Service Item
This is the first fitting where binaural hearing aids are clinically suitable to the Client's needs. The item includes a full rehabilitation program and hearing aid maintenance and batteries for 12 months from the date of fitting.
The range of services and outcomes covered by this item are described in the Hearing Rehabilitation Outcomes; Outcome 4, Fitting of Hearing Devices, Outcome 5, Follow-up and Outcome 6, Aftercare.
Only devices on the Schedule of Approved Devices may be fitted.
Conditions for Claiming
This item may be claimed only after a First Assessment or after a reassessment using a Return Voucher if the Client has not been previously fitted. The item may be claimed once only and applies where the Client has agreed to pay the annual hearing aid maintenance charge (unless “exempt”). The Date of Service for this item is the date of the first follow-up after the date of fitting.
First follow up should be undertaken not less than one week after the fitting, unless there are extenuating circumstances documented on the Client’s record.
This item is claimed where the Client is fitted binaurally.
The fitting range of the device should accommodate for the expected deterioration in hearing thresholds over the lifespan of the device. Should this condition not be met, providers must outline the justification for fitting the device in the supporting documentation including file notes.
The devices fitted must be listed on the Schedule of Approved Devices and the correct device codes used when claiming. Where a ‘Partially Subsidised’ device is fitted, the Service Provider is required to indicate, on the claim form, the device Category (C1, C2 or C3) from which the Client would have been fitted had they not been fitted with a Partially Subsidised Device. A Partially Subsidised maintenance fee may be charged only in relation to a device fitted from the Partially Subsidised Schedule of Approved Devices.
Where a Behind-the-Ear device is fitted a dispensing fee is added as part of this item.
Variation for Manual Payments
Item 641
Where a follow-up has not occurred or every reasonable effort has been made to arrange the follow-up appointment and the Client will not attend, the claim should be submitted to the Department for payment.
Supporting documentation including file notes and copies of correspondence should accompany the manual claim for payment. Where the Department accepts the claim for payment it will attract a fee equivalent to the cost of the device(s) and one half of the fitting item.
Any reassessment, and/or consequent refitting, within 12 months of the original fitting, does not attract a Scheduled Fee but is considered part of the original Hearing Rehabilitation Program unless specific approval to claim is given by the Department.
650 First hearing aid fitting, rehabilitation - Monaural
Description of Service Item
This is the first hearing aid fitting where one hearing aid is clinically suitable to the Client's needs. The item includes a full rehabilitation program and hearing aid repairs under warranty.
This item is for those Clients who do not accept the annual hearing aid maintenance charge. The warranty on the hearing aid, as detailed in the Device Supply Arrangements, must be utilised for hearing aid repairs.
The range of services and outcomes covered by this item are described in the Hearing Rehabilitation Outcomes; Outcome 4, Fitting of Hearing Devices, Outcome 5, Follow-up and Outcome 6, Aftercare.
Only devices on the Schedule of Approved Devices may be fitted.
Conditions for Claiming
This item may be claimed only after a First Assessment or after a reassessment using a Return Voucher if the Client has not been previously fitted. The item may be claimed once only and applies where the Client has not agreed to pay the annual hearing aid maintenance charge. The Date of Service for this item is the date of the first follow-up after the date of fitting.
First follow up should be undertaken not less than one week after the fitting, unless there are extenuating circumstances documented on the Client’s record.
This item is claimed where the Client is fitted monaurally.
The fitting range of the device should accommodate for the expected deterioration in hearing thresholds over the lifespan of the device. Should this condition not be met, providers must outline the justification for fitting the device in the supporting documentation including file notes.
The device fitted must be listed on the Schedule of Approved Devices and the correct device code used when claiming. Where a 'Top-Up' device is fitted, the Contracted Service Provider is required to indicate, on the claim form, the device Category (C1, C2 or C3) from which the Client would have been fitted had they not been fitted with a Partially Subsidised Device.
Where a Behind-the-Ear device is fitted a dispensing fee is added as part of this item.
Variation for Manual Payments
Item 651
Where a follow-up has not occurred or every reasonable effort has been made to arrange the follow-up appointment and the Client will not attend, the claim should be submitted to the Department for payment.
Supporting documentation including file notes and copies of correspondence should accompany the manual claim for payment. Where the Department accepts the claim for payment it will attract a fee equivalent to the cost of the device/s and one half of the fitting item.
Item 1
In the case of the aids being returned and credit being available to the Contracted Service Provider on return of the aids to the manufacturer, a payment equivalent to one half of the fitting item will be paid.
Any reassessment, and/or consequent refitting, within 12 months of the original fitting, does not attract a Scheduled Fee but is considered part of the original Hearing Rehabilitation Program unless specific approval to claim is given by the Department.
660 First hearing aid fitting, rehabilitation - Binaural
Description of Service Item
This is the first fitting where binaural hearing aids are clinically suitable to the Client's needs. The item includes a full rehabilitation program and hearing aid repairs under warranty.
This item is for those Clients who do not accept the annual hearing aid maintenance charge. The warranty on the hearing aid, as detailed in the Device Supply Arrangements, must be utilised for hearing aid repairs.
The range of services and outcomes covered by this item are described in the Hearing Rehabilitation Outcomes; Outcome 4, Fitting of Hearing Devices. Outcome 5, Follow-up and Outcome 6 Client Outcomes.
Only devices on the Schedule of Approved Devices may be fitted.
Conditions for Claiming
This item may be claimed only after a First Assessment or after a reassessment using a Return Voucher if the Client has not been previously fitted.
The item may be claimed once only and applies where the Client has not agreed to pay the annual hearing aid maintenance charge. The Date of Service for this item is the date of the first follow-up after the date of fitting.
First follow up should be undertaken not less than one week after the fitting, unless there are extenuating circumstances documented on the Client’s record.
This item is claimed where the Client is fitted binaurally.
The fitting range of the device should accommodate for the expected deterioration in hearing thresholds over the lifespan of the device. Should this condition not be met, providers must outline the justification for fitting the device in the supporting documentation including file notes.
The devices fitted must be listed on the Schedule of Approved Devices and the correct device codes used when claiming. Where a 'Partially Subsidised' device is fitted, the Contracted Service Provider is required to indicate, on the claim form, the device Category (C1, C2 or C3) from which the Client would have been fitted had they not been fitted with a Partially Subsidised Device.
Where a Behind-the-Ear device is fitted a dispensing fee is added as part of this item.
Variation for Manual Payments
Item 661
Where a follow-up has not occurred or every reasonable effort has been made to arrange the follow-up appointment and the Client will not attend, the claim should be submitted to the Department for payment.
Supporting documentation including file notes and copies of correspondence should accompany the manual claim for payment. Where the Department accepts the claim for payment it will attract a fee equivalent to the cost of the device/s and one half of the fitting item.
Item 2
In the case of the aids being returned and credit being available to the Contracted Service Provider on return of the aids to the manufacturer, a payment equivalent to one half of the fitting item will be paid.
Any reassessment, and/or consequent refitting, within 12 months of the original fitting, does not attract a Scheduled Fee but is considered part of the original Hearing Rehabilitation Program unless specific approval to claim is given by the Department.
635 First fitting, rehabilitation & maintenance - Assistive Listening Device (ALD)*
Description of Service Item
This is the first fitting where an ALD is suitable for the Client’s clinical needs and includes a full rehabilitation program and device maintenance and batteries for 12 months from the date of fitting.
The range of services and outcomes covered by this item are described in the Hearing Rehabilitation Outcomes; Outcome 4, Fitting of Hearing Devices, Outcome 5, Follow-up and Outcome 6, Aftercare.
Only ALD on the Schedule of Approved Devices may be fitted.
Conditions for claiming
This Service Item may only be claimed after a First Assessment or after a Reassessment using a Return Voucher if the Client has not been fitted previously with hearing aids or ALD under the Program. The Service Item may only be claimed once and applies where the Client has agreed to pay the annual hearing aid maintenance charge (unless “exempt”).
A follow-up is required to claim this item, the first follow up should be undertaken not less than one week after the fitting, unless there are extenuating circumstances documented on the Client’s record.
Only one assistive listening device may be fitted.
The device must be listed on the Schedule of Approved Devices and the correct device code used when claiming.
Variation for Manual Payments
Item 636
Where a follow-up has not occurred or every reasonable effort has been made to arrange the follow-up appointment and the Client will not attend, the claim should be submitted to the Department for payment.
Supporting documentation including file notes and copies of correspondence should accompany the manual claim for payment. Where the Department accepts the claim for payment it will attract a fee equivalent to the cost of the device/s and one half of the fitting item.
Any reassessment, and/or consequent refitting, within 12 months of the original fitting, does not attract a Scheduled Fee but is considered part of the original Hearing Rehabilitation Program unless specific approval to claim is given by the Department.
NB. All claims will be manual claims.
655 First fitting, rehabilitation -
Description of Service Item
This is the first fitting where an ALD is suitable for the Client’s clinical needs and includes a full rehabilitation program and Device repairs under warranty.
This item is for those Clients who do not accept the annual device maintenance charge. The warranty on the ALD, as detailed in the Device Supply Arrangements, must be provided for ALD repairs.
The range of services and outcomes covered by this item are described in the Hearing Rehabilitation Outcomes; Outcome 4, Fitting of Hearing Devices, Outcome 5, Follow-up and Outcome 6, Aftercare.
Only ALD on the Schedule of Approved Devices may be fitted.
Conditions for claiming
This Service Item may only be claimed after a First Assessment or after a Reassessment using a Return Voucher if the Client has not been fitted previously with hearing aids or ALD under the Program. The item may only be claimed once and applies where the Client has not agreed to pay the annual hearing aid.
A follow-up is required to claim this item, the first follow up should be undertaken not less than one week after the fitting, unless there are extenuating circumstances documented on the Client’s record.
Only one assistive listening device may be fitted. The device must be listed on the Schedule of Approved Devices and the correct device code used when claiming.
Variation for Manual Payments
Item 656
Where a follow-up has not occurred or every reasonable effort has been made to arrange the follow-up appointment and the Client will not attend, the claim should be submitted to the Department for payment.
Supporting documentation including file notes and copies of correspondence should accompany the manual claim for payment. Where the Department accepts the claim for payment it will attract a fee equivalent to the cost of the device/s and one half of the fitting item.
Item 1
In the case of the ALD being returned and credit being available to the Contracted Service Provider on return of the ALD to the manufacturer, a payment equivalent to one half of the fitting item will be paid.
Any reassessment, and/or consequent refitting, within 12 months of the original fitting, does not attract a Scheduled Fee but is considered part of the original Hearing Rehabilitation Program unless specific approval to claim is given by the Department.
NB. All claims will be manual claims.
680 Rehabilitation plus
Description of Service Item
This item is provided to assist Clients acquire and apply skills to maximise their communication abilities and better manage their hearing loss. The Rehabilitation Plus services are viewed as an extension of rehabilitation that begins at Assessment and continues through the Fitting and Follow-up appointments, with long term evaluation of outcomes marking completion of the initial hearing services program.
The range of outcomes covered by this item are described in the Hearing Rehabilitation Outcomes: Outcome 3, Hearing Rehabilitation Program and Outcome 6, Aftercare.
Conditions for Claiming
The item may be claimed once only for each Client.
This item is only available to New and Return Clients being fitted with Free-to-Client hearing aids or Assistive Listening Devices (ALDs) for the first time under the program with a Follow-up date of service on or after 1 January 2008.
Only Clients being fitted with Free-to-Client devices will be eligible.
Clients are only entitled to one Rehabilitation Plus Program.
This service item may be subcontracted.
To claim this item: a minimum of two appointments must take place after the Follow-up appointment. The two appointments must take place no earlier than 2 weeks after the follow up appointment and no longer than twelve month after the follow up appointment.
The session requirements are:
Group Sessions
Minimum of: 2 sessions
One hour duration per session
Group numbers are conducive to good learning. Significant others and communication partners can attend.
The sessions are managed by one or more Qualified Practitioner(s).
Individual Sessions
Minimum of: 2 sessions.
30 minutes duration per session.
Conducted by a Qualified Practitioner.
Mixed Sessions
Minimum of one of each of the above.
When lodging claims for Item 680 the QP number and site ID number should accurately reflect who provided (or managed, in respect of group sessions) the service and the site where services were provided.
If services are provided at a non-approved site, claim using your permanent site ID.
681 Rehabilitation plus
Description of Service Item
This item is provided to assist Clients acquire and apply skills to maximise their communication abilities and better manage their hearing loss. The Rehabilitation Plus services are viewed as an extension of rehabilitation that begins at Assessment and continues through the Fitting and Follow-up appointments, with long term evaluation of outcomes marking completion of the initial hearing services program.
The range of outcomes covered by this item are described in the Hearing Rehabilitation Outcomes: Outcome 3, Hearing Rehabilitation Program and Outcome 6, Aftercare.
Conditions for Claiming
The item may be claimed twice for each Client.
This item is only available to New and Return Clients being fitted with Free-to-Client hearing aids or Assistive Listening Devices (ALDs) for the first time under the program with a Follow-up date of service on or after 1 January 2008.
Only Clients being fitted with Free-to-Client devices will be eligible.
Clients are only entitled to one Rehabilitation Plus Program.
This service item may be subcontracted.
To claim this item a minimum of one appointment must take place no earlier than 2 weeks after the follow up appointment and no longer than twelve month after the follow up appointment. The session requirements are:
Group Session
1 session
One hour duration.
Group numbers are conducive to good learning. Significant others and communication partners can attend.
The session is managed by one or more Qualified Practitioner(s).
Individual Session
1 session of 30 minutes duration.
Conducted by a Qualified Practitioner.
When lodging claims for Item 681 the QP number and site ID number should accurately reflect who provided (or managed, in respect of group sessions) the service and the site where services were provided.
If services are provided at a non-approved site, claim using your permanent site ID.
Subsequent Initial Fitting
760 Fitting of a second aid & additional maintenance
Description of Service Item
This is a second hearing aid for a Client who has previously been fitted with one hearing aid and who requires a second hearing aid (in the other ear). It also covers Clients maintaining one hearing aid (monaural), fitted and paid for privately (outside the voucher system) and requiring a second hearing aid in the other ear. Maintenance and batteries for this second hearing aid is included in this item.
The range of services and outcomes covered under this item are described in the Hearing Rehabilitation Outcomes; Outcome 4, Fitting of Hearing Devices, Outcome 5, Follow-up; Outcome 6, Aftercare
Only Devices on the Schedule of Approved Devices may be fitted.
Conditions for Claiming
This item may be claimed only subsequent to a First Fitting - Monaural or Maintenance Service for a Hearing Aid Fitted outside the Voucher System - Monaural. The Date of Service for this item is the date of the first follow-up after the date of fitting.
First follow up should be undertaken not less than one week after the fitting unless there are extenuating circumstances documented on the Client’s record.
The device must be fitted to the opposite ear to that fitted under item 630, 650 or 790.
The fitting range of the device should accommodate for the expected deterioration in hearing thresholds over the lifespan of the device. Should this condition not be met, providers must outline the justification for fitting the device in the supporting documentation including file notes.
The device fitted must be listed on the Schedule of Approved Devices and the correct device code used when claiming. Where a 'Partially Subsidised' device is fitted, the Contracted Service Provider is required to indicate, on the claim form, the device Category (C1, C2 or C3) from which the Client would have been fitted had they not been fitted with a Partially Subsidised Device.
A Partially Subsidised maintenance fee may be charged only in relation to a device fitted from the Partially Subsidised Schedule of Approved Devices.
Where a Behind-the-Ear device is fitted a dispensing fee is added as part of this item.
Variation for Manual Payments
Item 761
Where a follow-up has not occurred or every reasonable effort has been made to arrange the follow-up appointment and the Client will not attend, the claim should be submitted to the Department for payment.
Supporting documentation including file notes and copies of correspondence should accompany the manual claim for payment.
Where the Department accepts the claim for payment it will attract a fee equivalent to the cost of the device/s and one half of the fitting item.
Any reassessment, and/or consequent refitting, within 12 months of the original fitting, does not attract a Scheduled Fee but is considered part of the original Hearing Rehabilitation Program unless specific approval to claim is given by the Department.
770 Fitting of a second aid without additional maintenance
Description of Service Item
This is a second hearing aid for a Client who has previously been fitted with one hearing aid and who requires a second hearing aid (in the other ear). It also covers Clients maintaining one hearing aid (monaural), fitted and paid for privately (outside the voucher system) and requiring a second hearing aid in the other ear. This item is for those Clients who do not accept the annual hearing aid maintenance charge.
The range of services and outcomes covered under this item are described in the Hearing Rehabilitation Outcomes; Outcome 4, Fitting of Hearing Devices, Outcome 5, Follow-up; Outcome 6, Aftercare.
Only Devices on the Schedule of Approved Devices may be fitted.
Conditions for Claiming
This item may be claimed only subsequent to a First Fitting - Monaural or Maintenance Service for a Hearing Aid Fitted Outside the Voucher System - Monaural. The Date of Service for this item is the date of the first follow-up after the date of fitting.
First follow up should be undertaken not less than one week after the fitting, unless there are extenuating circumstances documented on the Client’s record.
The device must be fitted to the opposite ear to that fitted under item 630, 650 or 790.
The item applies where the Client has not agreed to pay the annual hearing aid maintenance charge.
The fitting range of the device should accommodate for the expected deterioration in hearing thresholds over the lifespan of the device. Should this condition not be met, providers must outline the justification for fitting the device in the supporting documentation including file notes.
The Devices fitted must be listed on the Schedule of Approved Devices and the correct device codes used when claiming. Where a 'Partially Subsidised' device is fitted, the Contracted Service Provider is required to indicate, on the claim form, the device Category (C1, C2 or C3) from which the Client would have been fitted had they not been fitted with a Partially Subsidised Device.
Where a Behind-the-Ear device is fitted a dispensing fee is added as part of this item.
Variation for Manual Payments
Item 771
Where a follow-up has not occurred or every reasonable effort has been made to arrange the follow-up appointment and the Client will not attend, the claim should be submitted to the Department for payment.
Supporting documentation including file notes and copies of correspondence should accompany the manual claim for payment. Where the Department accepts the claim for payment it will attract a fee equivalent to the cost of the device/s and one half of the fitting item.
Where the reason for no follow-up appointment is that the Client is deceased the above payments will apply.
Item 1
In the case of the aid being returned and credit being available to the provider on return of the aid to the manufacturer, a payment equivalent to one half of the fitting item will be paid.
Any reassessment, and/or consequent refitting, within 12 months of the original fitting, does not attract a Scheduled Fee but is considered part of the original Hearing Rehabilitation Program unless specific approval to claim is given by the Department.
Annual Maintenance and Batteries (subsequent years)
700 Maintenance service & battery supply - Monaural
Clients must be informed that they will receive Device maintenance and repairs, and batteries, if the Client enters a maintenance agreement with the Service Provider and pays the annual maintenance fee. Contracted Service Providers and Qualified Practitioners must offer all Clients a maintenance agreement. (It is not mandatory for clients to accept the offer.)
Description of Service Item
This item covers full maintenance services and battery supply in the years subsequent to the year in which the Client was first fitted or first received maintenance and batteries for a hearing aid fitted outside the voucher system i.e. subsequent to the Client's first year in the program. This item applies to a monaural fitting.
For the purpose of the maintenance agreement, the term device includes the earmould and any other attachments necessary for the operation of the device.
Services to be provided as part of the Client’s maintenance agreement include adjustments to the Client's fitting, including the replacement of the earmould.
Contracted Service Providers are responsible for the supply of appropriate hearing device batteries to their Clients. As with repairs, this needs to be a timely service so Clients are not without the use of their devices for any significant period.
Repairs must be adequate to restore the device to its original physical condition, allowing for normal wear and tear.
Repairs must ensure that the electroacoustic characteristics and any other features prescribed by the Qualified Practitioner are matched to the original fitting.
It is desirable that repairs be attended to at the time the Client presents with the problem and that, if same day repair cannot be achieved, a loan device is provided if desired by the Client.
Conditions for Claiming
This item may be claimed on or after the anniversary of the first fitting or any subsequent maintenance claim where the Client has agreed to pay the hearing aid maintenance charge (unless “exempt”). This item cannot be claimed more than once every twelve months. This item is claimed where the Client is fitted monaurally.
The date of client signature on the Maintenance agreement must not be more than 45 days prior to the date on which maintenance services commence.
A Partially Subsidised maintenance fee can be charged only in relation to a device fitted from the Partially Subsidised Schedule of Approved Devices.
710 Maintenance service & battery supply - Binaural
Clients must be informed that they will receive device maintenance and repairs, and batteries, if the Client enters a maintenance agreement with the Contracted Service Provider and pays the annual maintenance fee. Contracted Service Providers and Qualified Practitioners must offer all Clients a maintenance agreement. (It is not mandatory for clients to accept the offer.)
Description of Service Item
This item covers full maintenance services and battery supply in the years subsequent to the year in which the Client was first fitted or first received maintenance and batteries for a hearing aid fitted outside the voucher system i.e. subsequent to the Client's first year in the program. This item applies to a binaural fitting.
For the purpose of the maintenance agreement, the term device includes the earmould and any other attachments (eg cords) necessary for the operation of the device.
Services to be provided as part of the Client’s maintenance agreement include adjustments to the Client's fitting, including the replacement of the earmould.
Contracted Service Providers are responsible for the supply of appropriate hearing device batteries to their Clients. As with repairs, this needs to be a timely service so Clients are not without the use of their devices for any significant period.
Repairs must be adequate to restore the device to its original physical condition, allowing for normal wear and tear.
Repairs must ensure that the electroacoustic characteristics and any other features prescribed by the Qualified Practitioner are matched to the original fitting.
It is desirable that repairs be attended to at the time the Client presents with the problem and that, if same day repair cannot be achieved, a loan device is provided if desired by the Client.
Conditions for Claiming
This item may be claimed on or after the anniversary of the first fitting or any subsequent maintenance claim where the Client has agreed to pay the hearing aid maintenance charge (unless “exempt”). This item cannot be claimed more than once every twelve months. This item is claimed where the Client is fitted binaurally.
The date of client signature on the Maintenance agreement must not be more than 45 days prior to the date on which maintenance services commence.
A Partially Subsidised maintenance fee can be charged only in relation to a device fitted from the Partially Subsidised Schedule of Approved Devices.
777 Payment of client contribution for maintenance & batteries for Department of Veterans' Affairs (DVA) eligible clients
Description of Service Item
This item covers the Client contribution for Maintenance and Battery supplies for hearing devices for Department of Veterans’ Affairs eligible Clients.
Conditions of Claiming
This item may be claimed where the Client holds a DVA Gold card or DVA white card (including hearing services). This item is claimed when claiming Fitting items that include Maintenance and Batteries (630, 635,640, 790,791) and with monaural or binaural Maintenance and Batteries claims (700, 710).
This item cannot be claimed more than once every twelve months. This item can only be claimed if the
- Client has not paid the provider the Client contribution for Maintenance and Batteries.
- The Date of Service for this item is the same as the Date of Service for the Maintenance and Batteries claim or the Date of Service for the fitting item that includes Maintenance and Batteries.
711 Relocated maintenance service & battery supply - Monaural aid
Description of Service Item
This item covers full maintenance services and battery supply for one year where a Client has relocated from one service provider to another. This item can only be claimed where the previous service provider has claimed maintenance within the year prior to the Client relocating. This item applies to a monaural fitting.
For the purpose of the maintenance agreement, the term device includes the earmould and any other attachments necessary for the operation of the device.
Services to be provided as part of the Client’s maintenance agreement include adjustments to the Client's fitting, including the replacement of the earmould.
Contracted Service Providers are responsible for the supply of appropriate hearing device batteries to their Clients. As with repairs, this needs to be a timely service so Clients are not without the use of their devices for any significant period.
Repairs must be adequate to restore the device to its original physical condition, allowing for normal wear and tear.
Repairs must ensure that the electroacoustic characteristics and any other features prescribed by the Qualified Practitioner are matched to the original fitting.
It is desirable that repairs be attended to at the time the Client presents with the problem and that, if same day repair cannot be achieved, a loan device is provided if desired by the Client.
Conditions for Claiming
This item can only be claimed where the Client has paid the annual maintenance contribution (unless “exempt”) to the previous provider as specified in the Schedule of Fees current at the time of service.
This item should be claimed as soon as a Client presents with a Return Voucher or a relocation Letter of Authority issued by the Department.
This item should be claimed where the Client is fitted monaurally.
722 Relocated maintenance service & battery supply - Binaural aids
Description of Service Item
This item covers full maintenance services and battery supply for one year where a Client has relocated from one service provider to another. This item can only be claimed where the previous Contracted Service Provider has claimed maintenance within the year prior to the Client relocating.
This item applies to a binaural fitting.
For the purpose of the maintenance agreement, the term device includes the earmould and any other attachments necessary for the operation of the device.
Services to be provided as part of the Client’s maintenance agreement include adjustments to the Client's fitting, including the replacement of the earmould.
Contracted Service Providers are responsible for the supply of appropriate hearing device batteries to their Clients. As with repairs, this needs to be a timely service so Clients are not without the use of their devices for any significant period.
Repairs must be adequate to restore the device to its original physical condition, allowing for normal wear and tear.
Repairs must ensure that the electroacoustic characteristics and any other features prescribed by the Qualified Practitioner are matched to the original fitting.
It is desirable that repairs be attended to at the time the Client presents with the problem and that, if same day repair cannot be achieved, a loan device is provided if desired by the Client.
Conditions for Claiming
This item can only be claimed where the Client has paid the annual maintenance contribution (unless “exempt”) to the previous Contracted Service provider as specified in the Schedule of Fees current at the time of service.
This item should be claimed as soon as a Client presents with a return voucher or a relocation authority letter issued by the Department.
This item should be claimed where the Client is fitted binaurally.
Maintenance for Hearing Aids Fitted Outside the Voucher System
790 Maintenance service & battery supply - Monaural (fitted outside voucher)
Clients must be informed that they will receive device maintenance and repairs, and batteries, if the Client enters a maintenance agreement with the Contracted Service Provider and pays the annual maintenance fee. Contracted Service Providers and Qualified Practitioners must offer all Clients a maintenance agreement. (It is not mandatory for clients to accept the offer.)
Description of Service Item
This item is for Clients with a monaural hearing aid fitted outside the Voucher System where the hearing aid is suitable to the Client’s needs, still in good working order and can be maintained for a reasonable period.
Once this item has been claimed, contact the Department prior to undertaking a device fitting under the client’s existing voucher.
For the purpose of the maintenance agreement, the term device includes the earmould and any other attachments necessary for the operation of the device.
Services to be provided as part of the Client’s maintenance agreement include adjustments to the Client's fitting, including the replacement of the earmould,
Contracted Service Providers are responsible for the supply of appropriate hearing device batteries to their Clients. As with repairs, this needs to be a timely service so Clients are not without the use of their devices for any significant period.
Repairs must be adequate to restore the device to its original physical condition, allowing for normal wear and tear.
Repairs must ensure that the electroacoustic characteristics and any other features prescribed by the Qualified Practitioner are matched to the original fitting.
It is desirable that repairs be attended to at the time the Client presents with the problem and that, if same day repair cannot be achieved, a loan device is provided if desired by the Client.
Conditions of Claiming
This item may be claimed on or after a First Assessment. This item may be claimed once only and applies where the Client has agreed to pay the annual hearing aid maintenance charge (unless “exempt”).
This item is claimed where the Client is fitted monaurally.
791 Maintenance service & battery supply - Binaural (fitted outside voucher)
Clients must be informed that they will receive device maintenance and repairs, and batteries, if the Client enters a maintenance agreement with the Contracted Service Provider and pays the annual maintenance fee. Contracted Service Providers and Qualified Practitioners must offer all Clients a maintenance agreement. (It is not mandatory for clients to accept the offer.)
Description of Service Item
This item is for Clients with binaural hearing aids fitted outside the Voucher System where those hearing aids are suitable to the Client's needs, still in good working order and can be maintained for a reasonable period.
Once this item has been claimed, contact the Department prior to undertaking a device fitting under the client’s existing voucher.
For the purpose of the maintenance agreement, the term device includes the earmould and any other attachments (eg cords) necessary for the operation of the device.
Services to be provided as part of the Client’s maintenance agreement include adjustments to the Client's fitting, including the replacement of the earmould.
Contracted Service Providers are responsible for the supply of appropriate hearing device batteries to their Clients.
Repairs must be adequate to restore the device to its original physical condition, allowing for normal wear and tear.
Repairs must ensure that the electroacoustic characteristics and any other features prescribed by the Qualified Practitioner are matched to the original fitting.
It is desirable that repairs be attended to at the time the Client presents with the problem and that, if same day repair cannot be achieved, a loan device is provided if desired by the Client.
Conditions for Claiming
This item may be claimed on or after a First Assessment. This item may be claimed once only and applies where the Client has agreed to pay the annual hearing aid maintenance charge (unless “exempt”).
This item is claimed where the Client is fitted Binaurally.
Return Clients
Reassessment, Refitting & Review
800 Reassessment
Description of Service Item
An assessment undertaken by a Qualified Practitioner or Provisional Practitioner under the supervision of a Qualified Practitioner, as authorised by a Return Client Voucher. This assessment can be performed by a Qualified Practitioner.
The range of services and outcomes covered under this item are described in the Hearing Rehabilitation Outcomes: Outcome 1, Assessment; Outcome 2, Referrals; Outcome 3, Hearing Rehabilitation Program.
(See Glossary for details of specific services).
Conditions for Claiming
The Client’s previous audiometric history must be reviewed as part of the Reassessment service.
This item can be claimed on the same date as the Client Review.
Should this item be claimed on the same date as a Client Review, the activities performed as part of this item must be different to those performed as part of the Client Review service. The Client’s record must clearly document the services performed as part of the Client Review separately from the Reassessment.
The Date of Service is the date of the Reassessment. This item may be claimed only where the Date of Service is on or after 1 November 1997 and where the Client has a Return Client Voucher. The service must be performed within the Voucher start and expiry dates.
The item may be claimed once only for each Return Client Voucher.
Any reassessment, and/or consequent refitting, within 12 months of the original fitting, does not attract a Scheduled Fee but is considered part of the original Hearing Rehabilitation Program unless specific approval to claim is given by the Department.
810 Audiological advice case management - Reassessment
Description of Service Item
Audiological advice which is necessary to provide a complete and accurate assessment as required to achieve the Hearing Rehabilitation Outcomes: Outcome 1, Assessment; Outcome 2, Referrals; Outcome 3, Hearing Rehabilitation Program. (See Glossary for details of specific services)
This item is subsequent to a Reassessment and services may be performed only by a Qualified Practitioner (Audiologist). The service consists of advice to a Qualified Practitioner (Audiometrist) to enable the completion of the Audiometrist’s assessment of a non-routine Client, required to achieve the Hearing Rehabilitation Outcomes: Outcome 1, Assessment and Outcome 2, Referrals.
Conditions for Claiming
This item can be claimed only where the Client has a Return Client Voucher. The service must be performed within the Voucher start and expiry dates.
The Client’s previous audiometric history must be reviewed as part of the Reassessment service. Where the client has relocated from another Contracted Service Provider, the previous history (Clinical Record) must be obtained and reviewed prior to the Reassessment Service Item being claimed.
This item may be claimed where a Client's Reassessment results have been referred to a Qualified Practitioner (Audiologist) by a Qualified Practitioner (Audiometrist) for audiological advice, required to achieve the Hearing Rehabilitation Outcomes: Outcome 1, Assessment and Outcome 2, Referrals.
This item may be subcontracted to a Qualified Practitioner Audiologist.
This item may be claimed only with an audiologist practitioner number.
The Date of Service is the date that the audiological advice and/or testing is provided.
This item can be claimed only in relation to an 800 item and the Date of Service must be on or after an 800 item.
820 Refitting & rehabilitation - Monaural
Description of Service Item
This is a hearing aid fitting subsequent to a reassessment (authorised by a Return Client Voucher) where one hearing aid is clinically suitable to the Client's needs. The item includes a full rehabilitation program.
Reasons for refitting must be consistent with those outlined in the eligibility criteria for refitting.
The range of services and outcomes covered by this item are described in the Hearing Rehabilitation Outcomes; Outcome 4, Fitting of Hearing Devices, Outcome 5, Follow-up; Outcome 6, Aftercare.
Only devices on the Schedule of Approved Devices may be fitted.
Conditions for Claiming
This item may be claimed only after a Reassessment has been performed. The Date of Service for this item is the date of the first follow-up after the date of fitting.
A claim cannot be submitted until after the fitting and first follow up have occurred.
First follow up should be undertaken not less than one week after the fitting, unless there are extenuating circumstances documented on the Client’s record.
This item is claimed where the Client requires one aid to be fitted.
The fitting range of the device should accommodate for the expected deterioration in hearing thresholds over the lifespan of the device. Should this condition not be met, providers must outline the justification for fitting the device in the supporting documentation including file notes.
The device fitted must be listed on the Schedule of Approved Devices and the correct device code used when claiming. Where a 'Partially Subsidised' device is fitted, the Contracted Service Provider is required to indicate, on the claim form, the device Category (C1, C2 or C3) from which the Client would have been fitted had they not been fitted with a Partially Subsidised Device. A Partially Subsidised maintenance fee may be charged only in relation to a device fitted from the Partially Subsidised Schedule of Approved Devices.
Where a Client has a hearing aid which was fitted, or replaced, under the Hearing Services Program and the need to refit a new device has been identified, the clinical reason/s for the refitting must be consistent with the eligibility criteria for refitting.
This item may be claimed once only for each Return Client Voucher issued.
Where a Behind-the-Ear device is fitted, a dispensing fee is added as part of this item.
Variation for Manual Payments
Item 821
Where every reasonable effort has been made to arrange the follow-up appointment and the Client will not attend, the unsigned claim should be forwarded to the Department for manual payment.
Supporting documentation, including file notes and copies of correspondence, should accompany the manual claim for payment. Where the Department accepts the claim for payment, it will attract a fee equivalent to the cost of the device/s and one half of the fitting item.
Item 1
In the case of the aid being returned and credit being available to the Contracted Service Provider on return of the aid to the manufacturer, a payment equivalent to one half of the fitting item will be paid.
Any reassessment, and/or consequent refitting, within 12 months of the original fitting, does not attract a Scheduled Fee but is considered part of the original Hearing Rehabilitation Program unless specific approval to claim is given by the Department.
825 Refitting & rehabilitation - ALD*
Description of Service Item
This is an ALD fitting subsequent to a reassessment (authorised by a Return Client Voucher) where an ALD is clinically suitable to the Client’s needs and the Client has previously been fitted with an ALD or hearing aid.
This item includes a full rehabilitation program.
The range of services and outcomes covered by this item are described in the Hearing Rehabilitation Outcomes; Outcome 4, Fitting of Hearing Devices, Outcome 5, Follow-up; Outcome 6, Aftercare.
Only ALD on the Schedule of Approved Devices may be fitted.
Conditions for claiming
This Service Item may only be claimed after a Reassessment has been performed.
Only one assistive listening device may be fitted. The device must be listed on the Schedule of Approved Devices and the correct device code used when claiming.
An ALD should only be fitted when the client will no longer be using hearing aids.
Where a Client has a hearing aid/s or an ALD which was fitted, or replaced, under the Hearing Services Program and the need to refit a new device has been identified, the clinical reason/s for the refitting must be consistent with the eligibility criteria for refitting.
A follow up is required to claim this item, the first follow-up should be undertaken not less than one week after the fitting unless there are extenuating circumstances.
Variation for Manual Payments
Item 826
Where a follow-up has not occurred or every reasonable effort has been made to arrange the follow-up appointment and the Client will not attend, the claim should be submitted to the Department for payment.
Supporting documentation including file notes and copies of correspondence should accompany the manual claim for payment. Where the Department accepts the claim for payment it will attract a fee equivalent to the cost of the device/s and one half of the fitting item.
Where the reason for no follow-up appointment is that the Client is deceased the above payments will apply.
Item 1
In the case of the ALD being returned and credit being available to the Contracted Service Provider on return of the ALD to the manufacturer, a payment equivalent to one half of the fitting item.
Any reassessment, and/or consequent refitting, within 12 months of the original fitting, does not attract a Scheduled Fee but is considered part of the original Hearing Rehabilitation Program unless specific approval to claim is given by the Department.
NB. All claims will be manual claims.
830 Refitting & rehabilitation - Binaural
Description of Service Item
This is a hearing aid fitting subsequent to a reassessment (authorised by a Return Client Voucher) where binaural hearing aids are clinically suitable to the Client's needs. The item includes a full rehabilitation program.
The range of services and outcomes covered by this item are described in the Hearing Rehabilitation Outcomes; Outcome 4, Fitting of Hearing Devices, Outcome 5, Follow-up; Outcome 6, Aftercare.
Only devices on the Schedule of Approved Devices may be fitted.
Conditions for Claiming
This item may be claimed only after a Reassessment has been performed. The Date of Service for this item is the date of the first follow-up after the date of fitting.
First follow up should be undertaken not less than one week after the fitting, unless there are extenuating circumstances documented on the Client’s record.
This item is claimed where the Client is fitted binaurally.
The fitting range of the device should accommodate for the expected deterioration in hearing thresholds over the lifespan of the device. Should this condition not be met, providers must outline the justification for fitting the device in the supporting documentation including file notes.
The device fitted must be listed on the Schedule of Approved Devices and the correct device code used when claiming. Where a 'Partially Subsidised' device is fitted, the Service Provider is required to indicate, on the claim form, the device Category (C1, C2 or C3) from which the Client would have been fitted had they not been fitted with a Partially Subsidised Device. A Partially Subsidised maintenance fee may be charged only in relation to a device fitted from the Partially Subsidised Schedule of Approved Devices.
Where a Client has a hearing aid/s which was fitted, or replaced, under the Hearing Services Program and the need to refit a new device has been identified, the clinical reason/s for the refitting must be consistent with the eligibility criteria for refitting.
This item may be claimed once only for each Return Client Voucher issued. Where a Behind-the-Ear device is fitted a dispensing fee is added as part of this item.
Variation for Manual Payments
Item 831
Where a follow-up has not occurred or every reasonable effort has been made to arrange the follow-up appointment and the Client will not attend, the claim should be submitted to the Department for payment.
Supporting documentation including file notes and copies of correspondence should accompany the manual claim for payment. Where the Department accepts the claim for payment it will attract a fee equivalent to the cost of the device/s and one half of the fitting item.
Item 2
In the case of the aids being returned and credit being available to the Contracted Service Provider on return of the aids to the manufacturer, a payment equivalent to one half of the fitting item will be paid.
Any reassessment, and/or consequent refitting, within 12 months of the original fitting, does not attract a Scheduled Fee but is considered part of the original Hearing Rehabilitation Program unless specific approval to claim is given by the Department.
930 Client review - Monaurally fitted
Description of Service Item
This item covers a review of client needs where the Client is experiencing less than optimal benefit or satisfaction with their device and it is more than 12 months from the date of fitting and more than 12 months from the last Client Review claim (or Aid Adjustment claim if prior to 1 July 2013).
The aims of this item are to give the practitioner greater flexibility in providing appropriate services in a timely and efficient manner and to extend the life of the current fitting. This item is not intended to be used to rectify a poor fitting by the practitioner. This item can be claimed on the same date as the Reassessment.
Should this item be claimed on the same date as a Reassessment, the activities performed as part of this item must be different to those performed as part of the Reassessment service. The Client’s record must clearly document the services performed as part of the Client Review separately from the Reassessment.
Note that as per the conditions for claiming the Reassessment service, only one Reassessment item can be claimed for each Return Client Voucher.
Conditions for Claiming
The client’s previous audiometric history, including hearing and communication goals must be reviewed as part of the Client Review service.
This item can only be claimed where a monaural fitting or refitting has previously been claimed for the Client.
A claim for these services would be indicated where the usual checks to exclude aid malfunction or external auditory meatus cerumen blockage has been completed and the client is still reporting difficulties.
In order to claim this item three or more of the following activities should be performed with supporting evidence on file
Hearing screening including an indication of middle ear status
Repetition of real ear insertion or aided threshold measurement
Resetting and/or reprogramming of hearing aid parameters to accommodate changes in hearing thresholds
Checking of real ear insertion or aided thresholds measurements with new hearing aid settings
Fitting of new earmoulds or modification of the current earmould/shell (eg. retubing, replacement of earhook)
Assessment of Loudness Discomfort Levels in relation to MPO settings
A review of client's expectations and appropriate use of communication strategies and tactics
A review of the client's aid management with re-instruction.
This item is only available where it is more than 12 months since the date of fitting. It can be claimed once every 12 months where it is clinically necessary.
The range of outcomes covered by this item are described in the Hearing Rehabilitation Outcomes; Outcome 6, Aftercare.
940 Client review - Binaurally fitted
Description of Service Item
This item covers a review of client needs where the Client is experiencing less than optimal benefit or satisfaction with their device and it is more than 12 months from the date of fitting and more than 12 months from the last Client Review claim (or Aid Adjustment claim if prior to 1 July 2013).
The aims of this item are to give the practitioner greater flexibility in providing appropriate services in a timely and efficient manner and to extend the life of the current fitting. This item is not intended to be used to rectify a poor fitting by the practitioner.
This item can be claimed on the same date as the Reassessment.
Should this item be claimed on the same date as a Reassessment, the activities performed as part of this item must be different to those performed as part of the Reassessment service. The Client’s record must clearly document the services performed as part of the Client Review separately from the Reassessment. Note that as per the conditions for claiming the Reassessment service, only one Reassessment item can be claimed for each Return Client Voucher.
Conditions for Claiming
The client’s previous audiometric history, including hearing and communication goals must be reviewed as part of the Client Review service.
This item can only be claimed where a binaural fitting or refitting has previously been claimed for that Client.
A claim for these services would be indicated where the usual checks to exclude aid malfunctions or external auditory meatus cerumen blockage has been completed and the client is still reporting difficulties.
In order to claim this item three or more of the following activities should be performed with supporting evidence on file
Hearing screening including an indication of middle ear status
Repetition of real ear insertion or aided threshold measurement
Resetting and/or reprogramming of hearing aid parameters to accommodate changes in hearing thresholds
Checking of real ear insertion or aided thresholds measurements with new hearing aid settings
Fitting of new earmoulds or modification of the current earmould/shell (eg. retubing, replacement of earhook)
Assessment of Loudness Discomfort Levels in relation to MPO settings
A review of client's expectations and appropriate use of communication strategies and tactics
A review of the client's aid management with re-instruction.
This item is only available where it is more than 12 months after date of fitting. It can be claimed once every 12 months where it is clinically necessary.
The range of outcomes covered by this item are described in the Hearing Rehabilitation Outcomes; Outcome 6, Aftercare.
Replacements
840 Replacement of lost or damaged beyond repair (DBR) hearing aid - Monaural
Description of Service Item
This item covers the replacement of a hearing aid when it has been lost or damaged beyond repair. The Department will require a statutory declaration from the Client for a lost aid, or letter from the manufacturer as evidence that the device has been damaged beyond repair and that a replacement hearing aid is required.
A device replacement fee, not exceeding the amount specified in the Schedule of Fees current at the time of service, shall be payable by the Client to the Service Provider except where
the Client holds a DVA Gold Card or a DVA White Card issued for hearing loss (see item 888)
the Client has dementia (see item 555)
the aid device was lost/DBR in hospital (see item 555)
the device was lost/DBR in a nursing home by the staff (see item 555)
the device was lost/DBR in the post (see item 555)
Only devices on the Schedule of Approved Devices may be fitted.
Conditions for Claiming
This item can be claimed at any time after a First Fitting or at any time after Maintenance for a hearing aid fitted outside the voucher system. The Date of Service for this item can be the same date as that of fitting. This item is for the replacement of one hearing aid.
Where a Behind-the-Ear device is fitted, a dispensing fee is added as part of this item.
The fitting range of the device should accommodate for the expected deterioration in hearing thresholds over the lifespan of the device. Should this condition not be met, providers must outline the justification for fitting the device in the supporting documentation including file notes.
850 Replacement of lost or DBR hearing aids - Binaural
Description of Service Item
This item covers the replacement of binaurally fitted hearing aids where both aids have been lost or damaged beyond repair. The Department will require a statutory declaration from the client for a lost aid, or letter from the manufacturer as evidence that the device has been damaged beyond repair and that replacement hearing aids are required.
A device replacement fee, not exceeding the amount specified in the Schedule of Fees current at the time of service, shall be payable by the Client to the Service Provider except where
the Client holds a DVA Gold Card or a DVA White Card issued for hearing loss (see item 888)
the Client has dementia (see item 555)
the aid device was lost/DBR in hospital (see item 555)
the device was lost/DBR in a nursing home by the staff (see item 555)
the device was lost/DBR in the post (see item 555)
Only Devices on the Schedule of Approved Devices may be fitted.
Conditions for Claiming
This item can be claimed at any time after a First Fitting or at any time after Maintenance for hearing aids fitted outside the voucher system. The Date of Service for this item can be the same date as that of fitting.
This item is for the replacement of two hearing aids.
Where a Behind-the-Ear device is fitted, a dispensing fee is added as part of this item.
The fitting range of the device should accommodate for the expected deterioration in hearing thresholds over the lifespan of the device. Should this condition not be met, providers must outline the justification for fitting the device in the supporting documentation including file notes.
888 Payment of client fee for replacement of aids(s) for DVA eligible clients
Description of Service Item
This item covers the contribution for Replacement Claims for Payment for Department of Veterans Affairs eligible Clients.
Conditions of Claiming
This item may be claimed where the Client holds a DVA Gold card or DVA white card (including hearing services). This item is claimed when claiming Replacement fitting items (840 and 850).
This item can only be claimed if the Client has not paid the provider the Client contribution for Replacement device(s). The Date of Service for this item is the same as the Date of Service for the Replacement fitting item.
555 Payment of client fee for replacement of aids(s) for exempt clients (other than DVA eligible clients)
Description of service item
This item covers the Client contribution for Replacement device (s) where, on a case by case basis, the Department determines that there are reasonable grounds to exempt the Client from the normal replacement payment (refer to items 840 and 850).
Conditions of Claiming
This item is claimed when claiming Replacement fitting items (840 and 850).
This item can only be claimed if the Client has not paid the provider the Client contribution for Replacement device(s) and one or more of the following exemption criteria apply with evidence documented on the Client’s file
the Client has dementia;
the device was lost/DBR in hospital;
the device was lost/DBR in a nursing home by the staff;
the device was lost/DBR in the post.
The Date of Service for this item is the same as the Date of Service for the Replacement fitting item.
Note All claims will be manual claims.
Spare Aid
960 Provision of spare hearing aid
Description of Service Item
In certain limited cases, a Client may be provided with a Spare Aid (see Spare Aid Guidelines for criteria.)
Conditions for claiming
This item can only be claimed where the service was provided on or after 1 July 2002 and a 630, 650 or 820 item has been claimed. The date of service must be on or after the date of service for the claim for items 630, 650 or 820.
Claims for provision of a spare aid will need to be lodged manually with the Department and must be accompanied by a completed copy of the Spare Aid Guidelines.
The Category Price of the spare aid will be paid as well as a one off maintenance fee equivalent to the monaural maintenance fee.
The fitting range of the device should accommodate for the expected deterioration in hearing thresholds over the lifespan of the device. Should this condition not be met, providers must outline the justification for fitting the device in the supporting documentation including file notes.
Note All claims will be manual claims.
A fee applies where a Behind the Ear (BTE) hearing aid is fitted, to cover the cost of the earmould and associated plumbing for these hearing aids. This fee is added to the fee for each hearing aid wherever a BTE hearing aid is fitted.
Variation for Manual Payment
Item 3
This is paid to the provider when a BTE is returned for credit and the mould is retained with the client record.
The Annual Hearing Aid Maintenance Charge Payable by the Client
This charge may be collected from a Client by the Contracted Service Provider, where the Client has agreed to the annual hearing aid maintenance charge, on or after the Date of Fitting for New Clients and as instructed by the Department for Clients receiving ongoing maintenance and batteries services.
This charge should not exceed the amount specified within the Schedule of Fees current at the time of service.
“Exempt” Clients are those Clients deemed to be exempt from paying the annual hearing aid maintenance charge by the Department of Veterans’ Affairs (DVA).
The annual hearing aid maintenance charge for exempt Clients will be paid to the Contracted Service Provider when a maintenance schedule fee is paid.
The Device Replacement Fee Payable by the Client
This charge must be collected from a Client by the Contracted Service Provider for a replacement Device.
This charge should not exceed the amount specified by the Department at the time of service.
“Exempt” Clients are those Clients deemed to be exempt from paying the device replacement fee by the Department of Veterans’ Affairs (DVA) or under exceptions as described in Items 840 and 850.
The device replacement fee for exempt Clients will be paid automatically to the Contracted Service Provider when a replacement schedule fee is paid.
*ALD - (Assistive Listening Device) – refer to Assistive Listening Devices (ALD) at ‘Prices for Main Schedule of Approved Devices’ in Schedule 4.
Schedule of Service Items (PDF 357 KB)