Health Professionals
Referrals for both children and adults for cochlear implants are accepted from ENT specialists, Audiologists, Advisers on Deaf Children and GPs. Adult clients can also self-refer.
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General guidelines
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No minimum/maximum age
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Adults must be medically cleared for surgery
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The Ministry of Health’s Cochlear Implant Services Specification excludes people who do not permanently live in New Zealand. As such, in addition to meeting the eligibility requirements for access to publicly funded health and disability services in New Zealand, evidence of living permanently in New Zealand is required for access to the Ministry of Health funded cochlear implant programme. This is provided through confirmation the person has a residency class visa (either permanent resident or a resident visa).
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Prior to referral to the Northern Cochlear Implant Programme, patients should have been fitted with appropriate hearing aids and found to receive little or no significant benefit.
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Generally, cochlear implant candidates should have spoken language as a primary goal. Appropriate exceptions may be those with additional physical or cognitive limitations. Candidacy in these cases is best determined by the cochlear implant assessment team. If in doubt please refer your patient for an assessment.
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Referral Guidelines for Children (under 19 years) April 2020
Please refer children whom you consider might be borderline – we are always happy to discuss cases with you on the phone.
Audiological Criteria
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Children who have a bilateral severe hearing loss or worse, from 1 kHz to 8 kHz in the better ear on ABR testing, or on a reliable unaided pure tone audiogram.
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Children with limited aided speech information above 2 kHz (as seen on speech-mapping).
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Children with a severe reverse sloping hearing loss or worse, whose speech and language are not progressing adequately.
Special Cases
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Meningitis- Children who have recently suffered from meningitis which has caused a bilateral or unilateral sensorineural hearing loss >65dBHL, should be urgently referred following diagnosis.
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Auditory Neuropathy Spectrum Disorder (ANSD) - children with a confirmed diagnosis of ANSD and who are not progressing in their speech and language development. Referrals are considered irrespective of PTA.
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Children with additional needs who also meet the audiological criteria will be accepted for assessment.
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Single Sided Deafness (SSD) or asymmetric hearing loss (where the worse ear has a severe hearing loss or worse, from 1 kHz to 8 kHz). Cochlear implants are not currently publically funded in NZ for these losses (except in the case of meningitis) but are available for private funding or if covered under ACC.
Age of referral
Early implantation is essential for best outcomes.
If you are in doubt about a possible referral please refer or call us to discuss.
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If you have any questions please contact our paediatric team:
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09 579 2333 or 0800 254 783
Referral Guidelines for Adults
Public funding criteria
Current funding criteria means that suitability for implantation is not the same as eligibility for public funding.
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To qualify for a cochlear implant assessment through the public program, the following criteria must be met.
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If clients meet the implantation criterion but not the public referral criterion they can be seen privately for assessment and information. If a client is interested in this option the Northern Cochlear implant Program is happy to provide a list of private providers in the region.
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Meningitis
When meningitis results in significant hearing loss (>65 dB HL) in either hearing ear. Note: because of the risk of ossification the program requests that we are made aware of the potential referral as soon as concerns develop, even if their speech audiometry would place them out of public criteria. There is no expectation that items on the check list are provided prior to acceptance on program.
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Clients with maximum scores on speech audiometry that are ≤ 60% in the better hearing ear (PI-max for monosyllabic words). To qualify for referral onto the public programme:
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Clients need to have had sufficient hearing (aided or unaided) to have developed some spoken language.
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Clients must be New Zealand Citizens or residents (and must actively live in NZ for a minimum of 187 days a year).
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Clients need to be well enough for surgery (this decision can be left to the CI team).
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Clients need to be good hearing aid wearers. If hearing has dropped to a level where there is no gain from aiding the program insists that ear moulds are provided so we can determine if there is a lip reading benefit from aiding.
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Clients must reside in the Northern region (see below). If they reside in the Southern region public referrals need to go to SCIP.
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Please note that there is no maximum age for referral and clients with additional needs are not excluded​.
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Private funding criteria
Clients must have at least one of the following:
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Hearing thresholds within the shaded region for the left or right ear. Depending on the aetiology it is possible that the client will meet aided threshold criteria but not unaided threshold criteria. (E.g. hyperacusis from Meniere’s) and unilateral cases will be considered (private implantation only).
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A severe hearing handicap as evidenced by speech audiometry that is <60% (Pimax on CVC or AB words) in either ear.
Prior to assessment a full diagnostic test needs to be completed and aids/ moulds need to be optimized. If prescriptive settings cannot be met please note what has been attempted to boost the gain and why this has not been successful. There is no age limits to implantation and clients with additional needs are not excluded but candidates must be well enough for surgery and the rehabilitation process.
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You can refer if thresholds fall anywhere within the shaded areas:
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Referrals can be made by an Audiologist, Audiometrist, ENT surgeon or GP. Clients can also self refer if required. For more information, contact our adult team:
09 579 2333 or 0800 254 783
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Assessment Process
When you refer a patient, the referral will be acknowledged and you will be updated as the assessment progresses.
When the assessment has been completed, both you and your patient will be notified as to whether he/she is a cochlear implant candidate.
The Ministry of Health provides separate funding for cochlear implants for children and adults each year. Once children are determined to be cochlear implant candidates, surgery is generally scheduled within 1-2 months. If candidacy is approved, adults are prioritised according to their clinical need and placed on a waiting list.
