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Referral Criteria & Candidacy

Could my patient benefit from cochlear implants?

Only 5% of US adults who could benefit from cochlear implants get treatment

Cochlear implants are an effective treatment option for patients with moderate to profound hearing loss. New advancements in implant technology enable cochlear implants to reach more patients than ever before with treatment, yet most patients who could benefit from cochlear implants do not seek treatment. If treatment is not recommended by an audiologist or other provider, patients may be unaware of their candidacy and options.

*This provides a recommendation only of when an adult may be referred for a cochlear implant evaluation, but does not guarantee candidacy based on indications. 

1. Zwolan TA, Schvartz-Leyzac KC, Pleasant T. Development of a 60/60 guideline for referring adults for a traditional Cochlear implant candidacy evaluation. Otol Neurotol 2020; 4t:895-900

Your patients may benefit if they:

Referral Criteria & Candidacy

Suffer from moderate to profound hearing loss.

Referral Criteria & Candidacy

Receive limited benefit from hearing aids.

Referral Criteria & Candidacy

Have no medical conditions that put them at risk during surgery.

When to consider cochlear implant evaluation for adults.

If your patient meets ANY of the criteria below, consider referring them for a full cochlear implant evaluation


Pure tone average greater than or equal to 60dB¹ in the better ear  (0.5, 1k, 2 kHz) 

Word Recognition

Unaided Word Recognition Score less than or equal to 60%¹ in the better ear

Daily Interactions

Does your patient experience ANY of the following:

  • Struggle to hear on the phone
  • Have difficulty understanding unfamiliar speakers
  • Withdraw from social events
  • Often need others to repeat themselves

FDA criteria to determine patient candidacy for cochlear implants

FDA criteria for cochlear implants


  • Individuals 18 years of age or older
  • Moderate to profound sensorineural hearing loss in both ears
  • Limited benefit from amplification defined by preoperative test scores of ≤ 50% sentence recognition in the ear to be implanted and ≤60% in the opposite ear or binaurally (HINT or other test materials)

(2-17 years)

  • Severe to profound sensorineural hearing loss
  • Limited benefit from binaural amplification
  • Multisyllabic Lexical Neighborhood Test (MLNT) or Lexical Neighborhood Test (LNT) scores ≤ 30%

(9-24 months)

  • Profound sensorineural hearing loss
  • Limited benefit from binaural amplification

Learn more about how you can support your patients along the continuum of hearing care.

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