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December 2016 Texas Medicaid Provider Procedures Manual

Vision and HearingServices Handbook : 1 General Information

1 General Information
The information in this handbook is intended for optometrists (doctors of optometry), ophthalmologists, and opticians who render services related to the eye and vision and for hearing aid professionals (fitters and dispensers, physicians, and audiologists) who provide hearing evaluations or fitting and dispensing services. The handbook provides information about Texas Medicaid’s benefits, policies, and procedures applicable to these providers.
All providers are required to read and comply with Subsection 4.1, “Enrollment”. In addition to required compliance with all requirements specific to Texas Medicaid, it is a violation of Texas Medicaid rules when a provider fails to provide healthcare services or items to Medicaid clients in accordance with accepted medical community standards and standards that govern occupations, as explained in Title 1 Texas Administrative Code (TAC) §371.1659. Accordingly, in addition to being subject to sanctions for failure to comply with the requirements that are specific to Texas Medicaid, providers can also be subject to Texas Medicaid sanctions for failure, at all times, to deliver healthcare items and services to Medicaid clients in full accordance with all applicable licensure and certification requirements including, without limitation, those related to documentation and record maintenance.
Refer to:
This handbook contains information about Texas Medicaid fee-for-service benefits. For information about managed care benefits, refer to the Medicaid Managed Care Handbook (Vol.2, Provider Handbooks).
Managed care carve-out services are administered as fee-for-service benefits. A list of all carve-out services is available in Section 9, “* Carve-Out Services” in the Medicaid Managed Care Handbook (Vol. 2, Provider Handbooks).

Texas Medicaid & Healthcare Partnership
CPT only copyright 2014 American Medical Association. All rights reserved.