Centers for Medicare and Medicaid Services (CMS) Approved the State Plan Amendment for Adult Optical Services

NC Medicaid received approval from CMS for the State Plan Amendment for Adult Optical Services. Effective Feb. 10, 2019, providers may bill for routine eye exams and visual aids for adult Medicaid beneficiaries with dates of service on or after Jan. 1, 2019. 

Providers should refer to Clinical Coverage Policy 6B, Routine Eye Examination and Visual Aids for Beneficiaries 21 Years of Age and Older for Medicaid guidelines regarding optical services for adult beneficiaries.

For more information, please refer to Clinical Coverage Policy 6B, Routine Eye Examination and Visual Aids for Beneficiaries 21 Years of Age and Older, at: https://medicaid.ncdhhs.gov/providers/clinical-coverage-policies.