Fee schedule: Noise-induced hearing loss program of care (NIHL POC)

Effective August 15, 2016

For people who start the NIHL POC on or after August 15, 2016*

NIHL POC Service block 1 (billed per ear)
Services included	Service code	Fee
Assessment	NIHL1L**	$425
Dispensing and fitting (within one to two weeks post-assessment) – including batteries for first year of use	NIHL1R**	$425
Initial follow-up (two to four weeks post-fitting)	N/A	N/A

NIHL POC Service block 2 (billed per ear)
Services included	Service code	Fee
Progress follow-up (90 days post-fitting)	NIHL2L**	$235
Additional follow-up visits as needed (up to 365 days post-assessment)	NNIHL2R**	$235

NIHL POC Reporting
Services included	Service code	Fee
NIHL POC Hearing Aid Outcome Report (Completed and submitted within five business days after progress follow-up)	NIHLOR	$40

Total NIHL POC for services (left-ear and right-ear hearing aids): $1,360

Additional resources for hearing health care providers. Please refer to the Program of care for noise induced hearing loss.

Notes:

NIHL POC Service Block fees cover all services associated with the worker’s hearing aids up to 1 year from date of assessment. Since the NIHL is inclusive, fees for (individual) services cannot be billed concurrently during the first year.
Hearing aid device is not included in this fee schedule
Additional supporting documents should be submitted to the WSIB as follows:
- Service Block 1 – audiogram (if required), manufacturer’s invoice following dispensing
- Service Block 2 – NIHL POC Hearing Aid Outcome report, NIHL POC Hearing Aid Outcome Questionnaire, and the manufacturer’s invoice (if not already submitted)

Important information

Bill electronically through TELUS Health as follows:
- Service Block 1 – Bill after dispensing and fitting (one to two weeks post-assessment)
- Service Block 2 – Bill after progress follow-up (90 days post-fitting)
Note: Although billing is allowed at the earliest possible timeframe for each Service Block, it is fully expected that all services up to four weeks post-fitting for Service Block 1 and up to one year post-assessment for Service Block 2 are delivered as required based on each person’s needs.
To successfully enter the NIHL POC bill, enter the service code on one line with the service date and corresponding fee.
For Service Block 1, the service date should be the date of assessment.
For Service Block 2, the service date should be the date of the progress follow-up visit (90 days post-fitting).
Payment for the last block of service will be withheld until the NIHL POC Hearing Aid Outcome Report is on file.
If HST is applicable, record it on the same bill but on a separate line using the service code ONHST

Complete and submit the NIHL POC Hearing Aid Outcome Report within five business days of the progress follow-up visit
The service date in the report should be the same as the service date used to bill Service Block 2
For those who need both right and left-ear hearing aids, only one NIHL POC Hearing Aid Outcome Report is required
If the person does not return for services under Service Block 2, submit the NIHL POC Hearing Aid Outcome Report and indicate they have not returned. Use the date of report as the service date