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3.3 Services/Benefits, Limitations and Prior Authorization
Optometric services may be reimbursed to optometrists.
Vision care benefits including prosthetic and non-prosthetic eyewear may be reimbursed to optometrists and ophthalmologists with specific limitations.
Note: In accordance with the Omnibus Reconciliation Act (OBRA) of 1986, Section 9336, a Doctor of Optometry is considered a physician, with respect to the provision of any item or service the optometrist is authorized to perform by state law or regulation.
Expenses for medical supplies, equipment, and other items that are not specifically made-to-order for the client are considered to have been incurred on the date the item is delivered and no reimbursement can be made to the provider.
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