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

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:

• 1T-1, General Ophthalmological Services  
• 1T-2, Special Ophthalmological Services 

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

• 6A, Routine Eye Examination and Visual Aids for Beneficiaries Under 21 Years of Age
• 6B – Routine Eye Examination and Visual Aids for Beneficiaries 21 Years of Age and Older

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

Contact

NCTracks Call Center - 800-688-6696