US · guidance
CMS Pub. 100-04, ch. 32, § 100.3
A/B MACs (Part B) Billing Procedures
Effective for dates of service performed on and after September 26, 2022, the following applies:
A/B MACs (Part B) shall accept claims for cochlear implantation devices and services for beneficiaries
meeting the coverage criteria listed under Publication 100-03, Chapter 1, section 50.3.
A/B MACs (Part B) shall accept claims for cochlear implantation devices and all related costs for
beneficiaries not meeting the coverage criteria listed under Publication 100-03, Chapter 1, Section 50.3
provided in an FDA-approved category B IDE clinical trial or a trial under the CMS Clinical Trial policy, that
is billed with the -Q0 modifier. The definition of the -Q0 modifier is, “Item or service provided in a Medicare
specified study.”
A/B MACs (Part B) shall accept claims for routine costs pertaining to beneficiaries not meeting the coverage
criteria listed under Publication 100-03, Chapter 1, Section 50.3 who are in a clinical trial under the clinical
trial policy that is billed with the -Q1 modifier. The definition of the -Q1 modifier is, “Routine clinical
service provided in a clinical research study that is in an approved clinical research study”
A/B MACs (Part B) shall accept claims for evaluation and therapeutic services related to cochlear
implantation.
NOTE: The -Q0/-Q1 modifier does not need to be applied to these services (92601-92604, 92507 & 92521-
92524).
These services should be billed on an approved electronic claim form or a paper CMS Form 1500.
History
(Rev. 11875; Issued:02-23-23; Effective: 09-26-22; Implementation: 03-24-23)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
7ae2e1000a877b63772bdf501096df9fcf7e0906862b75ba5c49721b7caef579
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