|
3.3.1 Services Performed in Long-Term Care Facilities
Vision care services performed in long-term care facilities (SNF or ICF) must be ordered by the attending physician. The physician's name and address or nine-character Texas Provider Identifier (TPI) must be documented on the claim.
Optometrist services provided in a skilled nursing facility (SNF) or intermediate care facility for persons with mental retardation (ICF-MR) may be reimbursed by Texas Medicaid if the client's attending physician has ordered the service and the order is included in the client's medical records at the facility. Providers must document the physician's name and address or provider identifier in Block 17 of the CMS-1500 claim form. Claims submitted without this information are listed on the R&S as incomplete and must be corrected and resubmitted for consideration of payment. Electronic claims of this nature will be rejected. Attending physician information for electronic claims must be noted in the appropriate field of an approved electronic claims format.
|
