Co-payments for Adult Optical Services

<p>List of applicable co-payments for adult Medicaid beneficiaries (21 years of age and older)</p>

Author: GDIT, (800) 688-6696

The following co-payments are applicable for adult Medicaid beneficiaries (21 years of age and older):

  • $3 - Routine eye exam (S0620 and S0621)
  • $3 - Refraction only (92015)
  • $2 - All visual aids (eyeglasses and medically necessary contact lenses)

In accordance with NCAC 22J. 0106, a provider may not withhold services from a beneficiary who is unable to pay a co-payment at the time the service is rendered. If a beneficiary is unable to pay, the provider may bill the beneficiary after the service is rendered for the unpaid co-payment.

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

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