Reimbursement for Newborn Hearing Screening


Baby sleeps during her newborn hearing screening.All general acute care hospitals except for children's hospitals will be reimbursed for newborn hearing screening services according to the Texas Medicaid prospective payment methodology based on the Diagnosis Related Group (DRG). The cost of providing this service is factored into the calculation of the DRG relative weights. 

Newborns who do not pass the newborn hearing screen [birth and/or outpatient screen(s), if applicable] will be referred for pediatric audiological diagnostic testing.

Neonatal intensive care unit (NICU) infants who do not pass the birth screen are referred directly for pediatric audiological diagnostic testing. These diagnostic tests may be billed using existing codes and fee structures.

Commercial Insurance

Newborn hearing screening is covered as part of the mandated health benefits listed by Texas Department of Insurance and required by Texas statute and regulations.

Children's Health Insurance Program 

Newborn hearing screening is a covered service through the Children's Health Insurance Program (CHIP). The birth admission hearing screen is covered as part of the DRG.


  • As with other uninsured services, the hospital will be at risk for loss of reimbursement for services provided to unfunded clients. However, the law still requires that the hospital provide the service.
  • The monitoring process must ensure that there is a match between Texas Vital Statistics reported births at an individual hospital and Texas Early Hearing Detection and Intervention (TEHDI). 

Last updated January 25, 2019