Topics Related to Optical Providers

Important Updates for Opticians

For more information, join the Virtual Office Hours webinar Thursday, June 5, 2025, at noon.

Reminder: Medical and Routine Eye Exams and Visual Aids are not Covered Under Telehealth

Guidance for ophthalmologists, optometrists and opticians regarding clinical coverage policies for medical and routine eye exams and visual aids.

Correction to NC Medicaid Eyeglasses Dispensing Fee Billing and Payment Bulletin

In the Feb. 1, 2022, bulletin, incorrect Maximum Allowable Rates were entered in the NC Medicaid Eyeglasses Dispensing Fee Schedule table.

Expanded NCTracks Contacts for Optical Providers

Provides information for providers of beneficiaries enrolled in NC Medicaid Direct and NC Medicaid Managed Care

NC Medicaid Eyeglasses Dispensing Fee Billing and Payment

Eyeglasses dispensing fee schedule, coverage of eyeglasses components, and provider billing and Medicaid payment.

Closure of Tear Duct Using Plug; CPT Code 68761: Billing Guidelines

Medicaid requires claims for CPT code 68761 be billed with one of four modifiers.

Eyeglasses Prior Approval and Dispensing Fee Claims Submission When a Beneficiary Transitions to NC Medicaid Direct – Aug. 30, 2021

This replaces the bulletin, published on Aug. 4, 2021

Prior Authorizations Covered When a Beneficiary Transitions to NC Medicaid Direct

When an NC Medicaid Managed Care member becomes part of a population exempted or excluded, they are disenrolled and transition to NC Medicaid Direct.

Eyeglasses Prior Approval and Dispensing Fee Claims Submission When a Beneficiary Transitions to NC Medicaid Direct

Providers must submit ALL eyeglasses prior approval requests for NC Medicaid Direct beneficiaries and health plan members to NCTracks.

Prior Authorizations for Medically Necessary Contact Lenses When a Beneficiary Transitions NC Medicaid Direct

Providers must submit a contact lens prior approval request to NCTracks for a beneficiary who has transferred back to NC Medicaid Direct.