Alabama Administrative Code
Title 560 - ALABAMA MEDICAID AGENCY
Chapter 560-X-17 - EYE CARE SERVICES
Section 560-X-17-.02 - Physician Services For Diseases, Injuries, Or Congenital Defects

Universal Citation: AL Admin Code R 560-X-17-.02

Current through Register Vol. 43, No. 02, November 27, 2024

(1) If medically necessary, treatment may include, contact lenses (for keratoconus, aphakia, high magnification difference between lenses), when requested in writing and prior authorized by Medicaid.

(2) Orthoptics (eye exercises) must be prior authorized by Medicaid. Full information justifying medical necessity (including number of sessions anticipated) must be sent in writing to Medicaid before this service is begun.

(3) Eyeglass lens changes, within lens specifications authorized by Medicaid, may be supplied when needed because of visual changes due to eye disease, surgery, or injury.

Author: Jacquelyn King, Program Manager; Medical Support

Statutory Authority: State Plan; Title XIX, Social Security Act; 42 C.F.R. Part 401, et seq.

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