Conditions for Claiming

1

Aid returned for credit – Monaural/one aid

• This item should only be claimed if the client is not motivated to be fitted with a different device/s in the near future (≤2 months).
• If the fitting claim has already been submitted, providers must recover this item before submitting the item 1.
• The date of service matches the original date of fitting of the returned device.
• The total benefit amount is half the original fitting item e.g. item 650, 770 or 820, please see the Schedule of Service Fees

Portal claim

$0.00

$0.00

Item 650

$220.20

Item 770

$41.75

Item 820

$189.25

2

Aid returned for credit – Binaural/two aids

• This item should only be claimed if the client is not motivated to be fitted with a different device/s in the near future (≤2 months).
• If the fitting claim has already been submitted, providers must recover this item before submitting the item 2.
• The date of service matches the original date of fitting of the returned devices.
• The total benefit amount is half the original fitting item e.g. item 660 or 830, please see the Schedule of Service Fees

Portal claim

$0.00

$0.00

Item 660

$264.15

Item 830

$188.10

3

Dispensing fee for hearing aids returned for credit

• This is paid to the provider when a Behind-the-Ear (BTE) is returned for credit (RFC).
• An item 1 or 2 has been submitted.
• The date of service matches the item 1 or 2.
• If two BTE devices are returned, you can submit this claim twice.

Portal claim

$0.00

$0.00

$27.00

4

Remote controls

• This item can only be claimed once against a client’s voucher.
• A fitting item has already been e-Claimed and appears on the client’s claim history.
• The total benefit amount is the same amount as shown on the manufacturer’s invoice (excluding postage and handling).
• Enter the amount in the “Item Benefit (not liable for GST)” field only. Please check the item benefit doesn’t default to $0.00.
• A manufacturer invoice for the remote control must be kept on the client’s file.
• Item benefit must be ≤ $200 - Please email hearing@health.gov.au for approval to fit remotes over $200 with the manufacturers invoice attached.
• If a remote control is lost or damaged beyond repair, approval is required prior to providing and claiming another item 4 on the same voucher. Email a completed statutory declaration to the program.
• Supporting documentation justifying a remote control fitting should be kept on the client file. The client must have a chronic physical disability that impedes their ability to independently manage the user controls of their hearing device/s.

Portal claim

$0.00

$0.00

$1.00

to $200.00

6

Miscellaneous item – Must be pre-approved by the program

• A non-scheduled device has been approved, OR
• A buying service provider is submitting a split payment

Portal claim

N/A

N/A

N/A

555

Payment of client contribution for lost/damaged beyond repair (DBR) device/s for exempt clients

• This item cannot be claimed for DVA Gold or White Card eligible clients.
• The client meets one or more of the exemption criteria (client has dementia or the device was lost/DBR in a hospital/nursing home/post).
• The item 840/850 is e-Claimed and approved and appears on the client’s claim history prior to the submission of the item 555.
• The date of service of the item 555 matches the 840/850 date of service.

e-Claim

$0.00

$0.00

$41.60

600

First Assessment

• The date of service is within the voucher period.
• The item can be claimed once for each client.
• If an item 33/333 is recorded on the client claim history or if the client voucher number begins with alpha-characters, this item cannot be claimed. Instead, claim an item 800.

e-Claim

$0.00

$0.00

$141.90

610

Audiological case management

• This can only be claimed for non-routine clients where an Audiometrist refers to an Audiologist.
• The item can be claimed once for each client.
• An item 610 can only be claimed with, or immediately following an assessment item 600.
• The date of service is the date that the audiological advice and/or testing is completed.
• This item can only be claimed using an Audiologists Qualified Practitioner number.
• For more information on item 610, please see Claiming Information

e-Claim

$0.00

$0.00

$45.00

630

Initial fitting, rehabilitation and maintenance – Monaurally fitted/one ear

• No previous fitting[1] has occurred.
• An assessment is provided and claimed prior to this fitting.
• The Minimum Hearing Loss Threshold (MHLT) criterion is met.
• The client contribution for annual battery and maintenance is paid by the client or is waived at your discretion.
• The client attends a successful follow-up appointment.
• The date of service is the date of the successful follow-up appointment and must be more than 5 working days[2] from the fitting date.

e-Claim

$6.20

$0.62

$453.47

631

Initial fitting and maintenance with no follow up appointment – Monaurally fitted/one ear

• No previous fitting has occurred.
• An assessment is provided and claimed prior to this fitting.
• The MHLT criterion is met.
• The client contribution for annual battery and maintenance is paid by the client or is waived at your discretion.
• The client does not attend a follow up appointment after several attempts to contact them, OR
• The client relocates away before the follow up appointment and has kept the device.
• The date of service matches the date of fitting of the device.

e-Claim

$6.20

$0.62

$227.07

635

Initial fitting, rehabilitation and maintenance – Assistive Listening Devices (ALD)

• No previous fitting has occurred.
• An assessment is provided and claimed prior to this fitting.
• The MHLT criterion is met.
• The client contribution for annual battery and maintenance is paid by the client or is waived at your discretion.
• The client attends a successful follow-up appointment.
• The date of service is the date of the successful follow-up appointment and must be more than 5 working days from the fitting date.

e-Claim

$9.03

$0.90

$204.75

636

Initial fitting ALD and maintenance with no follow up appointment

• No previous fitting has occurred.
• An assessment is provided and claimed prior to this fitting.
• The MHLT criterion is met.
• The client contribution for annual battery and maintenance is paid by the client or is waived at your discretion.
• The client does not attend a follow up appointment after several attempts to contact them, OR
• The client relocates away before the follow up appointment and has kept the ALD.
• The date of service matches the date of fitting of the device.

e-Claim

$9.03

$0.90

$102.85

640

Initial fitting, rehabilitation and maintenance – Binaurally fitted/both ears

• No previous fitting has occurred.
• An assessment is provided and claimed prior to this fitting.
• The MHLT criterion is met.
• The client contribution for annual battery and maintenance is paid by the client or is waived at your discretion.
• The client attends a successful follow up appointment.
• The date of service is the date of the successful follow-up appointment and must be more than 5 working days from the fitting date.

e-Claim

$19.13

$1.91

$568.46

641

Initial fitting with no follow up appointment – Binaurally fitted/both ears

• No previous fitting has occurred.
• An assessment is provided and claimed prior to this fitting.
• The MHLT criterion is met.
• The client contribution for annual battery and maintenance is paid by the client or is waived at your discretion.
• The client does not attend a follow up appointment after several attempts to contact them, OR
• The client relocates away before the follow up appointment and has kept the devices.
• The date of service matches the date of fitting of the device.

e-Claim

$19.13

$1.91

$285.21

650

Initial fitting and rehabilitation without maintenance – Monaurally fitted/one ear

• No previous fitting has occurred.
• An assessment is provided and claimed prior to this fitting.
• The MHLT criterion is met.
• The client contribution for annual battery and maintenance is not paid by the client.
• The client attends a successful follow-up appointment.
• The date of service is the date of the successful follow-up appointment and must be more than 5 working days from the fitting date.

e-Claim

$0.00

$0.00

$440.45

651

Initial fitting with no follow up appointment or maintenance – Monaurally fitted/one ear

• No previous fitting has occurred.
• An assessment is provided and claimed prior to this fitting.
• The fitting is provided after the assessment.
• The MHLT criterion is met.
• The client contribution for annual battery and maintenance is not paid by the client.
• The client does not attend a follow up appointment after several attempts to contact them, OR
• The client relocates away before the follow up appointment and has kept the device.
• The date of service matches the date of fitting of the device.

e-Claim

$0.00

$0.00

$220.25

655

Initial fitting and rehabilitation without maintenance – ALD

• No previous fitting has occurred.
• An assessment is provided and claimed prior to this fitting.
• The MHLT criterion is met.
• The client contribution for annual battery and maintenance is not paid by the client.
• The client attends a successful follow-up appointment.
• Do not claim this item if the fitting is unsuccessful.
• The date of service is more than 5 working days from the fitting date.

e-Claim

$0.00

$0.00

$185.80

656

Initial fitting ALD with no follow up appointment or maintenance

• No previous fitting has occurred.
• An assessment is provided and claimed prior to this fitting.
• The MHLT criterion is met.
• The client contribution for annual battery and maintenance is not paid by the client.
• The client does not attend a follow up appointment after several attempts to contact them, OR
• The client relocates away before the follow up appointment and has kept the ALD.
• The date of service matches the date of fitting of the device.

e-Claim

$0.00

$0.00

$92.90

660

Initial fitting and rehabilitation without maintenance – Binaurally fitted/both ears

• No previous fitting has occurred.
• An assessment is provided and claimed prior to this fitting.
• The MHLT criterion is met.
• The client contribution for annual battery and maintenance is not paid by the client.
• The client attends a successful follow-up appointment.
• The date of service is the date of the first follow-up appointment and must be more than 5 working days from the fitting date.

e-Claim

$0.00

$0.00

$528.30

661

Initial fitting with no follow up appointment or maintenance – Binaurally fitted/both ears

• No previous fitting has occurred.
• An assessment is provided and claimed prior to this fitting.
• The MHLT criterion is met.
• The client contribution for annual battery and maintenance is not paid by the client.
• The client does not attend a follow up appointment after several attempts to contact them, OR
• The client relocates away before the follow up appointment and has kept the devices.
• The date of service matches the date of fitting of the device.

e-Claim

$0.00

$0.00

$264.15

670

Rehabilitation Service

• This item provides an alternative for clients who are not proceeding with a hearing device fitting but who would benefit from receiving training and strategies to manage their hearing loss.
• An assessment is provided and claimed prior to this service.
• No previous fitting item has been claimed.
• An assessment is claimed prior to this appointment.
• Two rehab appointments must take place.
• The first appointment is to provide a rehabilitation service consultation, and the second appointment is to provide rehabilitation service follow up.
• This item can only be claimed once per client.

e-Claim

$0.00

$0.00

$205.10

680

Rehabilitation Plus – 2 sessions

• An assessment is provided and claimed prior to this service.
• The client is fitted with fully subsidised device/s for the first time (i.e. client has never been fitted through the program).
• Providers cannot claim this item if a client is fitted with partially subsidised devices at no cost to the client.
• Two sessions are required (this item can only be claimed once) within 12 months of the follow-up date.

e-Claim

$0.00

$0.00

$145.30

681

Rehabilitation Plus – 1 session

• An assessment is provided and claimed prior to this service.
• No previous fitting item has been claimed.
• The client is fitted with fully subsidised device/s for the first time (i.e. client has never been fitted through the program).
• One session is required (this item can only be claimed twice) within 12 months of the follow-up date.
• Providers cannot claim this item if a client is fitted with partially subsidised devices at no cost to the client.

e-Claim

$0.00

$0.00

$72.15

700

Maintenance and battery supply – Monaurally fitted/one ear

• The client is fitted to one ear.
• Please ensure the client’s fitting configuration is monaural in the portal prior to claiming.
• The previous battery and maintenance claim has expired.
• The client contribution for annual battery and maintenance is paid by the client or is waived at your discretion.
• This claim can be signed and paid up to 45 days prior to maintenance expiry.
• The date of service will be the expiry date of the maintenance agreement.

e-Claim

$36.58

$3.66

$76.81

710

Maintenance and battery supply – Binaurally fitted/both ears

• Client must be fitted to both ears.
• Please ensure the client’s fitting configuration is binaural in the portal prior to claiming.
• The previous battery and maintenance claim has expired.
• The client contribution for annual battery and maintenance is paid by the client or is waived at your discretion.
• This claim can be signed and paid up to 45 days prior to maintenance expiry.
• The date of service will be the expiry date of the maintenance agreement.

e-Claim

$36.58

$3.66

$203.49

711

Relocated maintenance and battery supply – Monaurally fitted/one ear

• The client is fitted to one ear.
• Please ensure the client’s fitting configuration is monaural in the portal prior to claiming.
• The client’s current battery and maintenance agreement has not expired.
• If the client relocates to several providers within a 12 month period, subsequent item 711 claims will need to be submitted through the HSO portal.
• If the client relocates back to the original provider, this provider won’t be able to claim an item 711 if the 700 hasn’t expired.

e-Claim

$58.60

$5.86

$123.06

722

Relocated maintenance and battery supply – Binaurally fitted/both ears

• The client is fitted to both ears.
• Please ensure the client’s fitting configuration is binaural in the portal prior to claiming.
• The client’s current battery and maintenance agreement has not expired.
• If the client relocates to several providers within a 12 month period, subsequent item 722 claims will need to be submitted through the HSO portal.
• If the client relocates back to the original provider, they won’t be able to claim an item 722 if the 710 hasn’t expired.

e-Claim

$118.93

$11.89

$249.74

760

Subsequent initial fitting, rehabilitation and maintenance

• The client has only received a monaural aid fitting and is now eligible to have the opposite ear fitted under the program.
• The MHLT criterion is met.
• A current item 700 has not yet expired.
• The client attends a successful follow-up appointment.
• The date of service is the date of the first follow-up appointment and must be more than 5 working days from the fitting date.
• If the client has previously been fitted with an ALD (against an old voucher), an item 820 must be claimed to the same ear before the item 760 to the opposite ear is submitted through the HSO portal.

e-Claim

$16.28

$1.63

$117.63

761

Subsequent initial fitting and maintenance with no follow up appointment

• The client has only received a monaural aid fitting and is now eligible to have the opposite ear fitted under the program.
• The MHLT criterion is met.
• A current item 700 has not yet expired.
• The client does not attend a follow up appointment after several attempts to contact them, OR
• The client relocates away before the follow up appointment and has kept the device.
• The date of service matches the date of fitting of the device.
• If the client has previously been fitted with an ALD (against an old voucher), an item 820 must be claimed to the same ear before the item 760 to the opposite ear is submitted through the HSO portal.

e-Claim

$16.28

$1.63

$59.63

770

Subsequent initial fitting and rehabilitation without maintenance

• The client has only received a monaural aid fitting and is now eligible to have the opposite ear fitted under the program.
• The MHLT criterion is met.
• The client contribution for annual battery and maintenance is not paid by the client.
• The client attends a successful follow-up appointment.
• The date of service is the date of the first follow-up appointment and must be more than 5 working days from the fitting date.
• If the client has previously been fitted with an ALD (against an old voucher), an item 820 must be claimed to the same ear before the item 760 to the opposite ear is submitted through the HSO portal.

e-Claim

$0.00

$0.00

$83.45

771

Subsequent initial fitting with no follow up appointment or maintenance

• The client has only received a monaural aid fitting and is now eligible to have the opposite ear fitted under the program.
• The MHLT criterion is met.
• The client contribution for annual battery and maintenance is not paid by the client.
• The client does not attend a follow up appointment after several attempts to contact them, OR
• The client relocates away before the follow up appointment and has kept the device.
• The date of service matches the date of fitting of the device.
• If the client has previously been fitted with an ALD (against an old voucher), an item 820 must be claimed to the same ear before the item 760 to the opposite ear is submitted through the HSO portal.

e-Claim

$0.00

$0.00

$41.75

777

Payment of client contribution for maintenance/batteries for Department of Veterans’ Affairs (DVA) eligible clients

• The client is DVA Gold Card or White (for hearing loss) Card eligible.
• DVA PCC clients are not entitled to this claim item.
• DVA will only pay this item on the client behalf when a successful follow-up appointment has occurred.
• This item is submitted in the same batch as an item 790/791 or 700/710.
• This item cannot be submitted in the same batch as other claims e.g. 940, 800 etc.
• The date of service matches the date of service of the initial fitting items 630/635/640, or maintenance items 790/791/700/710.
• This item must be claimed in conjunction with an item 630/635/640 or 790/791/700/710.

e-Claim

$22.03

$2.20

$46.25

790

Maintenance and battery supply - Monaurally fitted/one ear (Private devices)

• This item can only be claimed once only for each client.
• An assessment is provided and claimed prior to this service.
• No fitting claim has ever been claimed under the program.
• One ear is fitted with a private aid.
• The client contribution for annual battery and maintenance is paid by the client or is waived at your discretion.
• The private aid is suitable and likely to last for the life of the voucher.

The private device details (device type and device code) have been added to the client’s service history in the portal.

• If at a later date the client is initially fitted through the program (on the same voucher), you can claim an initial fitting item 630/650 to the same ear or item 640/660 to both ears, OR
• If at a later date the client is initially fitted to the same ear through the program (on a return voucher), please claim a refitting item 820, OR
• If at a later date the client is initially fitted to the same ear and subsequently fitted to the opposite ear through the program (on a return voucher), please claim items 820 to the aided ear and 760 to the unaided ear.

e-Claim

$36.58

$3.66

$76.81

791

Maintenance and battery supply - Binaurally fitted/both ears (Private devices)

• This item can only be claimed once only for each client.
• An assessment is provided and claimed prior to this service.
• No fitting has ever been claimed under the program.
• Both ears are fitted with private aids.
• The client contribution for annual battery and maintenance is paid by the client or is waived at your discretion
• The private aids are suitable and likely to last for the life of the voucher.

The private device details (device type and device code) have been added to the client’s service history in the portal.

• If at a later date the client is initially fitted to both ears through the program (on the same voucher), please claim an initial fitting item 640/660, OR
• If at a later date the client is fitted to both ears through the program (on a return voucher), please claim a refitting item 830.

e-Claim

$96.90

$9.69

$203.49

800

Reassessment

• This item can be claimed once on a client’s current voucher.

An initial assessment (item 600) must have been claimed on a previous voucher, OR

• Clients are considered return binaural clients if the client voucher begins with 3 alpha-characters i.e. WAG000000X or an item 33 or 333 has previously been claimed.

e-Claim

$0.00

$0.00

$141.90

810

Audiological case management

• This can only be claimed for non-routine clients where an Audiometrist refers to an Audiologist.
• The date of service is the date that the audiological advice and/or testing is requested.
• An item 810 can only be claimed with, or immediately following an assessment item 800.
• This item may be claimed only with an Audiologists Qualified Practitioner (Audiologist) number.
• This item can be claimed once on a client’s current voucher.
• For more information on item 810, please see Claiming Information

e-Claim

$0.00

$0.00

$45.00

820

Refitting and rehabilitation – Monaurally fitted/one ear

• The client has been previously fitted on the same ear against a previous voucher.
• The Eligibility Criteria for Refitting (ECR) is met.
• The client attends a successful follow-up appointment.
• The date of service is the date of the first follow-up appointment and must be more than 5 working days from the fitting date.
• If the client was previously fitted to both ears, update their fitting configuration on the portal to monaural prior to claiming.
• Can only be claimed once per voucher with the exception of when one provider has claimed an item 820/821 to one ear and another provider refits the opposite ear, the second item 820 should be submitted through the HSO portal. 

e-Claim

$0.00

$0.00

$378.50

821

Refitting with no follow up appointment – Monaurally fitted/one ear

• The client has been previously fitted on the same ear against a previous voucher.
• The ECR is met.
• The client does not attend a follow up appointment after several attempts to contact them, OR
• The client relocates away before the follow up appointment and has kept the device.
• If the client was previously binaurally fitted, update their fitting configuration on the portal to monaural prior to claiming.
• The date of service matches the date of fitting of the device.
• Can only be claimed once per voucher with the exception of when one provider has claimed an item 820/821 to one ear and another provider refits the opposite ear, the second item 821 can be submitted through the HSO portal. 

e-Claim

$0.00

$0.00

$189.25

825

Refitting and rehabilitation – ALD

• The client has been fitted against a previous voucher.
• The ECR is met.
• The client attends a successful follow-up appointment.
• The date of service is more than 5 working days from the date of fitting.
• Can only be claimed once per voucher.

e-Claim

$0.00

$0.00

$130.70

826

ALD refitting with no follow up appointment

• The client has been fitted against a previous voucher.
• The ECR is met.
• The client does not attend a follow up appointment after several attempts to contact them, OR
• The client relocates away before the follow up appointment and has kept the ALD.
• The date of service matches the date of fitting of the device.
• Can only be claimed once per voucher.

e-Claim

$0.00

$0.00

$65.35

830

Refitting and rehabilitation – Binaurally fitted/both ears

• The client has been binaurally fitted against a previous voucher.
• The ECR is met.
• The client attends a successful follow-up appointment.
• The date of service is the date of the successful follow-up appointment and must be more than 5 working days from the fitting date.
• Can only be claimed once per voucher.

e-Claim

$0.00

$0.00

$376.20

831

Refitting with no follow up appointment – Binaurally fitted/both ears

• The client has been binaurally fitted against a previous voucher.
• The ECR is met.
• The client does not attend a follow up appointment after several attempts to contact them, OR
• The client relocates away before the follow up appointment and has kept the devices.
• The date of service matches the date of fitting of the device.
• Can only be claimed once per voucher.

e-Claim

$0.00

$0.00

$185.50

840

Replacement of Lost/DBR Device – Monaurally fitted/one ear

• The replacement device is the same as the lost/damaged device.
• If the lost/damage device is no longer available on the schedule, the device must be replaced with a similar style/category tier.
• This item includes a dispensing fee for Behind-the-Ear devices.
• If replacing an ALD the item 840 must be submitted through the HSO portal.
• A Statutory Declaration must be completed by the client stating how, when and where and is kept on the client file, OR
• A letter from the manufacturer stating the devices are damaged beyond repair is kept on the client file.

e-Claim

$0.00

$0.00

$71.00

850

Replacement of Lost/DBR Device – Binaurally fitted/both ears

• The replacement device is the same as the lost/damaged devices.
• If the lost/damage devices are no longer available on the schedule, the devices must be replaced with a similar style/category tier.
• This item includes a dispensing fee for Behind-the-Ear devices.
• A Statutory Declaration must be completed by the client stating how, when and where and is kept on the client file, OR
• A letter from the manufacturer stating the devices are damaged beyond repair is kept on the client file.

e-Claim

$0.00

$0.00

$103.60

888

Payment of Client Contribution for Lost/DBR device/s for Department of Veterans Affairs Eligible Clients

• The client is DVA Gold Card or White Card (for hearing loss)
• DVA PCC clients are not entitled to this claim item.
• DVA will pay this item on the client’s behalf.
• This item is submitted in the same batch as an item 840/850.
• This item cannot be submitted in the same batch as other claim items e.g. 940/800.
• The date of service matches the date of service of the 840 or 850 items.
• A Statutory Declaration must be completed by the client stating how, when and where and is kept on the client file, OR
• A letter from the manufacturer stating the devices are damaged beyond repair is kept on the client file.

e-Claim

$0.00

$0.00

$41.60

930

Client Review – Monaurally fitted/one ear

• The client is fitted to one ear only.
• At least three of the activities listed in the Schedule of Service Items have been performed.
• The date of service is more than 12 months from the last 930 claim, OR
• The date of service is more than 12 months from the initial fitting or last refitting date.
• This item can be claimed on the same date as a reassessment.
• If the client was originally binaural and is now monaural ensure the client’s fitting configuration is ‘monaural’ on the portal, this item must be claimed through the HSO portal moving forward.

e-Claim

$0.00

$0.00

$80.00

940

Client Review – Binaurally fitted/both ears

• The client is fitted to both ears.
• At least three of the activities listed in the Schedule of Service Items have been performed.
• The date of service is more than 12 months from the last 940 claim, OR
• The date of service is more than 12 months from the initial fitting or last refitting date.
• This item can be claimed on the same date as a reassessment (800).

e-Claim

$0.00

$0.00

$123.95

960

Spare Aid

• The client meets the fitting criteria for a spare aid
• Can only be claimed once per client.
• The client is fitted to one ear or has a BiCROS device
• If the spare aid is lost or damaged, a Statutory Declaration must be signed by the client prior to e-claiming an item 840.
• If the spare aid is no longer suitable (i.e. insufficient reserve gain), a statutory declaration must be signed by the service provider prior to e-Claiming an item 840.

e-Claim

or

Portal claim where BiCROS is the current fitting

$0.00

$0.00

$75.50