TMPPM 2008 > Texas Medicaid Services > Vision Care (Optometrists, Opticians) > Benefits and Limitations

45.4.4.1 Dispensing Requirements

Providers must be able to dispense standard size frames at no cost to the eligible client. Providers must also show each eligible client a minimum of three styles of zylonite frames for male or female, child or adult, in a choice of three colors. The provider may also show combination frames of zylonite and metal. The Texas Medicaid Program can reimburse the zylonite maximum allowable amount for a combination frame. If the cost of frames exceeds the Medicaid maximum allowable fee, the client may be billed the difference of the billed amount. If there is no Medicaid coverage for the eyewear, the client is responsible for the entire amount.

Clients must acknowledge their choice of eyewear beyond program limitations by signing the "Vision Care Eyeglass Patient (Medicaid Client) Certification Form".