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Optometry Services Reinstated as a Covered Medi-Cal Benefit - System Change Effective 7-26-10
July 27, 2010
Download file: rates - maximum reimbursement for optometry services.doc Associated File: rates - maximum reimbursement for optometry services.doc


On July 1, 2009, the Department of Health Care Services (DHCS) excluded several optional benefits, including optometry services, from coverage for adult beneficiaries under the Medi-Cal program pursuant to Assembly Bill X3 5 (Chapter 20, Statutes of 2009-10, Third Extraordinary Session).

 

System changes have been implemented July 26, 2010 to reinstate optometry services as a covered benefit for adult beneficiaries under the Medi-Cal program. Optometry services include diagnostic, ancillary and supplemental procedures used for the evaluation of the visual system. Current Optional Benefit Exclusion policy involving services relating to eyeglasses and other eye appliances will remain unchanged with the reinstatement of optometry services, with the exception of bandaged contact lenses HCPCS code V2599, which will be covered for eligible beneficiaries based on medical necessity. For a list of optometry services now payable for adult beneficiaries under the Medi-Cal program, click on the attachment above.

 

CPCA is working to clarify the state’s obligation to reimburse health centers retroactively for services rendered after last July’s elimination.

 

Any questions regarding this reinstatement of services may be referred to Molly Brassil at mbrassil@cpca.org.


 
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