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.

Medical and routine eye exams and visual aids are not covered under the NC Medicaid Clinical Coverage Policy 1H, Telehealth, Virtual Communications and Remote Patient Monitoring. Therefore, providers may not utilize the modalities included in Clinical Coverage Policy 1H when providing a medical or routine eye exam or providing visual aid services for NC Medicaid Direct beneficiaries or NC Medicaid Managed Care members.

Clinical coverage policy for medical eye exams can be found at:

Clinical coverage policy for routine eye exams and visual aids can be found at:

Payment for services rendered in a manner not in compliance with the corresponding clinical coverage policy may be subject to recoupment.


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