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December 2016 Texas Medicaid Provider Procedures Manual

Vision and HearingServices Handbook : 4 Vision Care Professionals : 4.3 Services, Benefits, Limitations, and Prior Authorization : 4.3.7 Vision Services for Prosthetic Eyewear : Intraocular Lens (IOL) and Additional Eyewear
Intraocular lenses are benefits of Texas Medicaid. If conventional eyewear is medically necessary in addition to the IOL, the IOL is considered the prosthetic device, and the eyewear and any replacements are considered nonprosthetic.
Refer to:
Subsection, “Intraocular Lens (IOL)” in Medical and Nursing Specialists, Physicians, and Physician Assistants Handbook (Vol. 2, Provider Handbooks) for more information about IOL benefits.
Subsection 4.3.6, “Nonprosthetic Eyeglasses or Contact Lenses” in this handbook for more information about nonprosthetic eyewear.

Texas Medicaid & Healthcare Partnership
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