Arkansas Administrative Code
Agency 016 - DEPARTMENT OF HUMAN SERVICES
Division 06 - Medical Services
Rule 016.06.07-003 - State Plan #2006-014; Visual Care Update #82; Section V-DMS-0101
Current through Register Vol. 49, No. 9, September, 2024
Section II Visual Care
Providers
Visual Care Program providers meeting the following criteria are eligible for participation in the Arkansas Medicaid Program:
A. Provider must be licensed by the State Board of Optometry to practice in his or her state. A current copy of the optometrist's license must be submitted with the provider application for participation. Subsequent licensure must be provided when issued.
B. Provider must be enrolled in the Title XVIII (Medicare) Program.
C. Provider must complete a provider application (form DMS-652), a Medicaid contract (form DMS-653) and a Request for Taxpayer Identification Number and Certification (Form W-9). View or print the provider application (form DMS-652), the Medicaid contract (form DMS-653) and the Request for Taxpayer Identification Number and Certification (Form W-9).
D. Enrollment as a Medicaid provider is conditioned upon approval of a completed provider application and the execution of a Medicaid provider contract. Persons and entities that are excluded or debarred under any state or federal law, regulation or rule are not eligible to enroll, or to remain enrolled, as Medicaid providers.
E. The Visual Care provider must adhere to all applicable professional standards of care and conduct.
Visual Care Program providers in Arkansas and the bordering states of Louisiana, Mississippi, Missouri, Oklahoma, Tennessee and Texas will be enrolled as routine services providers.
Routine Services Providers
A. Provider will be enrolled in the program as a regular provider of routine services.
B. Reimbursement will be available for all visual care services covered in the Arkansas Medicaid Program.
C. Claims must be filed according to Section 240.000 of this manual. This includes assignment of ICD-9-CM and HCPCS codes for all services rendered.
A non-bordering state provider may download the provider manual
and provider application materials from the Arkansas Medicaid website,
Visual care providers who accept a Medicaid beneficiary for an eye examination with refraction must follow these guidelines:
Visual care providers are required to keep the following records and, upon request, must immediately furnish the records to authorized representatives of the Division of Medical Services, the state Medicaid Fraud Control Unit, representatives of the Department of Health and Human Services and the Centers for Medicare and Medicaid Services:
Supplier
The Arkansas Medicaid Program uses a single optical laboratory selected through a competitive bid process to furnish eyeglasses for eligible Medicaid beneficiaries. The Medicaid Program's Medical Assistance Unit depends on visual care providers to assist in monitoring the performance of the contractor both in quality of product and timeliness of delivery. The following procedures must be followed:
A. The Medical Assistance Unit welcomes positive and negative comments regarding the optical laboratory's performance. All comments regarding the optical laboratory's performance must be made on the Vendor Performance Report. View or print the Vendor Performance Report. The provider will complete the Vendor Performance Report at any time a beneficiary verbally expresses dissatisfaction with their eyeglasses.
B. Vendor Performance Reports should be mailed to the Division of Medical Services, Medical Assistance Unit. View or print the Division of Medical Services, Medical Assistance Unit contact information.
C. The Medical Assistance Unit, upon receipt of the Vendor Performance Report, will log and investigate the complaint.
D. A copy of the report is kept on file and may be a factor in awarding future contracts.
To assist the Medical Assistance Unit in investigating your report, the following guidelines are suggested when submitting a Vendor Performance Report::
Copies of the Vendor Performance Report may be obtained by calling the Division of Medical Services, Medical Assistance Unit. View or print the Division of Medical Services, Medical Assistance Unit contact information.
204.000 The Visual Care Provider's Role in the Child Health Services
(EPSDT) Program
The Arkansas Medical Assistance Program includes a Child Health Service, Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Program for eligible individuals less than 21 years of age. The purpose of this program is to detect and treat health problems in their early stages.
If you are a Child Health Services (EPSDT) provider, please refer to the Child Health Services (EPSDT) provider manual for additional information.
Visual care providers interested in enrolling in the Child Health Services (EPSDT) Program should contact the Central Child Health Services Office. View or print contact information for the Central Child Health Services Office.
Visual care providers must bill Child Health Services (EPSDT) on the DMS-694 claim form using the proper Child Health Services (EPSDT) procedure codes found in the Child Health Services (EPSDT) provider manual. Ancillary charges, such as lab and X-ray, associated with Child Health Services (EPSDT) should be listed on the DMS-694. View a DMS-694 sample form.
Any enrolled Arkansas Medicaid provider rendering services not covered by the Arkansas Medicaid Program to a participant in the Child Health Services (EPSDT) Program who has been referred for services as a result of an EPSDT screen will be reimbursed for the services rendered if the services are medically necessary and permitted under federal Medicaid regulations.
Any Arkansas Medicaid provider may bill for non-covered services if the services are provided to a participant in the Child Health Services (EPSDT) Program who has been referred due to an EPSDT screen. The services must be medically necessary and permitted under federal Medicaid regulations.
When a provider performs a Child Health Services (EPSDT) screen and refers the patient to another provider for services not covered by Arkansas Medicaid, the referring provider must give the beneficiary a prescription for the non-covered services. The prescription must indicate the services being prescribed and state the services are being prescribed due to an EPSDT screen. In order for the non-covered service to be eligible for Medicaid payment, the referral documentation must be available for review. A provider who performs a Child Health Services (EPSDT) screen may also provide services resulting from the screen, if appropriate.
The prescription for services must be dated by the referring provider. The prescription for the non-covered service is acceptable if services were prescribed and the prescription is dated within the applicable periodicity schedule, not to exceed a maximum of 12 months.
211.000 Introduction
The Arkansas Medicaid Program covers visual care services of Medicaid beneficiaries within restrictions set in federal and state guidelines. The following paragraphs are a general summary of the program coverage. Detailed coverage, prior authorization, reference information and other requirements may be found in those specific sections within this manual.
212.000 Contact Lens
The Visual Care Program makes contact lenses available to eligible beneficiaries under the following guidelines:
213.200 Coverage and Limitations of the Adult Program
213.300 Exclusions in the Adult Program
214.100 Scope of the Under Age 21 Program
The primary purpose of this program is for the screening, examination, diagnosis and treatment of conditions of the eye for the prescribing and fitting of eyeglasses, contact lenses and low vision aids for eligible beneficiaries under 21 years of age.
214.200 Coverage and Limitations of the Under Age 21 Program
214.300 Exclusions in the Under Age 21 Program
216.000 Medical Procedures Billable by Optometrists
Optometrists are allowed to bill for certain procedures for office medical services and special services previously payable only to physicians.
The office medical services provided by an optometrist will be limited to twelve visits per state fiscal year for individuals age 21 and over. The benefit limit will be used in conjunction with four other programs. These programs are physicians' services, medical services provided by dentists, rural health clinic services and certified nurse-midwife services. Beneficiaries will be allowed twelve visits per state fiscal year for office medical services furnished by an optometrist, medical services furnished by a dentist, physicians' services, rural health clinic services, certified nurse-midwife services or a combination of the five. Extensions beyond the twelve-visit limit may be provided if medically necessary. Office medical services for beneficiaries under age 21 in the Child Health Services (EPSDT) Program are not benefit limited. Procedure codes, description of services and special billing instructions are located in Section 240.000 of this manual.
All beneficiaries of vision and medical eye care may have direct access to optometrists as primary eye care providers, independent of the primary care provider (e.g., physician, Federally Qualified Health Center (FQHC), etc.).
232.000 Rate Appeal Process
A provider may request reconsideration of a program decision by writing to the Assistant Director, Division of Medical Services. This request must be received within 20 calendar days following the application of policy and/or procedure or the notification of the provider of its rate. Upon receipt of the request for review, the Assistant Director will determine the need for a program/provider conference and will contact the provider to arrange a conference if needed. Regardless of the program decision, the provider will be afforded the opportunity for a conference, if he or she so wishes, for a full explanation of the factors involved and the program decision. Following review of the matter, the Assistant Director will notify the provider of the action to be taken by the Division within 20 calendar days of receipt of the request for review or the date of the program/provider conference.
If the decision of the Assistant Director, Division of Medical Services is unsatisfactory, the provider may then appeal the question to a standing Rate Review Panel established by the Director of the Division of Medical Services, which will include one member of the Division of Medical Services, a representative of the provider association and a member of the Department of Health and Human Services (DHHS) Management Staff, who will serve as chairman.
The request for review by the Rate Review Panel must be postmarked within 15 calendar days following the notification of the initial decision by the Assistant Director, Division of Medical Services. The Rate Review Panel will meet to consider the question(s) within 15 calendar days after receipt of a request for such appeal. The question(s) will be heard by the panel and a recommendation will be submitted to the Director of the Division of Medical Services.
241.000 Introduction to Billing
Visual care providers use the Visual Care DMS-26-V claim form or the CMS-1500 form to bill the Arkansas Medicaid Program on paper for services provided to eligible Medicaid beneficiaries. Each claim may contain charges for only one beneficiary.
Section III of this manual contains information about Provider Electronic Solutions (PES) and other available options for electronic claim submission.
The following services are covered under the Arkansas Medicaid Program.
Procedure Code |
Required Modifier |
Description |
Coverage |
|
Under 21 |
Over 21 |
|||
DIAGNOSTIC AND ANCILLARY SERVICES |
||||
S0620 |
ROUTINE OPTHALMOLOGICAL EXAMINATION INCLUDING REFRACTION; NEW PATIENT This service must include the following: case history, general health observation, external exam of the eye and adnexa, ophthalmoscopic examination, determination of refractive state, basic sensorimotor and binocularity examination. It may also include initiation of diagnostic and treatment programs or referral. |
yes |
yes |
|
S0621 |
- |
ROUTINE OPTHALMOLOGICAL EXAMINATION INCLUDING REFRACTION; ESTABLISHED PATIENT |
yes |
yes |
This service must include the following: case history, general health observation, external exam of the eye and adnexa, ophthalmoscopic examination, determination of refractive state, basic sensorimotor and binocularity examination. It may also include initiation of diagnostic and treatment programs or referral. |
||||
92340 |
FITTING OF SPECTACLES, EXCEPT FOR APHAKIA: MONOFOCAL Fitting includes measurement of anatomical facial characteristics, the writing of laboratory specifications, and the final adjustment of the spectacles to the visual axes and anatomical topography. |
yes |
yes |
|
92370 |
REPAIR AND REFITTING OF SPECTACLES Repair and refitting spectacles; except for aphakia |
yes |
yes |
|
99173 |
UB |
SCREENING TEST OF VISUAL ACUITY, QUANTITATIVE, BILATERAL This procedure must include at minimum three of the services listed under procedure code V0100. This code may not be billed in conjunction with procedure code V0100. |
yes |
yes |
CONTACT LENS SERVICES |
||||
S0592 |
COMPREHENSIVE CONTACT LENS EVALUATION This service must include the following: biomicroscopy, multiple ophthalmometry, case history, tear flow, measurement of ocular adnexa, initial tolerance evaluation, and may include other tests. This procedure does not include contact lens and should be billed in conjunction with other contact lens procedure codes. If billing this code, DO NOT bill S0620 or S0621. Contacts and glasses may be ordered using this code. |
yes |
yes |
|
S0512 |
SUPPLYING AND FITTING OF CONTACT LENS (SOFT) Spherical, aphakic, lenticular, toric, hydrophilic (per lens) |
yes W/PA |
yes W/PA |
|
S0512 |
SUPPLYING AND FITTING OF CONTACT LENS (GAS PERMEABLE) Spherical, aphakic, lenticular, toric, prism ballast (per lens) |
yes W/PA |
yes W/PA |
|
V2501 |
UA |
SUPPLYING AND FITTING OF KERATOCONUS LENS (HARD OR GAS PERMEABLE) - per lens |
yes W/PA |
yes W/PA |
S0512 |
- |
SUPPLYING AND FITTING OF MONOCULAR LENS (HARD OR GAS PERMEABLE)-per lens |
yes W/PA |
yes W/PA |
V2501 |
U1 |
SUPPLYING AND FITTING OF MONOCULAR LENS (SOFT LENS) -per lens |
yes W/PA |
yes W/PA |
S0512 |
SUPPLYING AND FITTING OF CONTACT LENS (SOFT) Spherical, aphakic, lenticular, toric, hydrophilic (per lens) |
yes W/PA |
yes W/PA |
|
S0500 |
- |
DISPOSABLE CONTACTS (PER LENS) |
Yes W/PA |
W/PA |
LOW VISION SERVICES |
||||
92002 |
UB |
LOWVISION EVALUATION |
yes W/PA |
yes W/PA |
SUPPLEMENTAL PROCEDURES |
||||
92081 |
- |
VISUAL FIELD - Electronic or Goldmann |
yes |
yes |
92081 |
- |
VISUAL FIELD - Confrontation Perimetry |
yes |
yes |
MISCELLANEOUS SERVICES |
||||
92100 |
UB |
TONOMETRY This procedure will only be covered when medically necessary. These conditions include, but are not limited to, diabetes, hypertension and age of the patient. |
yes |
yes |
V2623 |
- |
EYE PROSTHESIS Prosthetic eye, plastic, custom |
yes W/PA |
yes W/PA |
V2624 |
" |
POLISHING OF PROSTHESIS Polishing/resurfacing of ocular prosthesis |
yes W/PA |
yes W/PA |
92065 |
- |
ORTHOPTIC AND PLEOPTIC TRAINING WITH CONTINUING MEDICAL DIRECTION AND EVALUATION |
yes W/PA |
no |
92060 |
SENSORIMOTOR EXAMINATION Wth multiple measurements of ocular deviation (eq, restrictive or paretic muscle with diplopia) with interpretation and report (separate procedure). |
yes W/PA |
no |
|
96111 |
DEVELOPMENTAL TESTING Extended (includes assessment of motor, language, social, adaptive and/or cognitive functioning by standardized developmental instruments) with interpretation and report. |
Yes W/PA |
no |
|
CONTACT LENS REPLACEMENT |
||||
92326 |
" |
HARD LENS (PER LENS) This procedure code does not include a professional fee. |
yes W/PA |
no |
92326 |
" |
SOFT LENS (PER LENS) This procedure code does not include a professional fee. |
yes W/PA |
no |
92326 |
" |
GAS PERMEABLE (PER LENS) This procedure code does not include a professional fee. |
yes W/PA |
no |
92326 |
- |
APHAKIC LENS Post-operative cataract. |
Yes W/PA |
yes W/PA |
V2799 |
- |
UNSPECIFIED PROCEDURE |
yes |
yes |
If Medicare denies a claim for services provided to a beneficiary eligible for both Medicare and Medicaid, the claim will not cross over to Medicaid automatically. Therefore, the Visual Care claim form DMS-26-V should be submitted to EDS along with the Explanation of Medicare Benefits (EOMB) explaining the reason for Medicare's denial.
NOTE: A copy of the Medicare EOMB must be attached to the claim and must match the dates of service on the claim form.
Medicare/Medicaid crossover claims are discussed in Section III of this manual.
243.150 Office Medical Services
The office medical services provided by an optometrist are limited to twelve (12) visits per state fiscal year (July 1 through June 30) for beneficiaries age 21 and older. The benefit limit will be used in conjunction with four other programs: physicians' services, medical services provided by dentists, rural health clinic services and certified nurse-midwife services. Beneficiaries will be allowed twelve visits per state fiscal year for office medical services furnished by an optometrist, medical services furnished by a dentist, physicians' services, rural health clinic services and certified nurse-midwife services or a combination of the five. Extensions beyond the twelve-visit limit may be provided if medically necessary. Office medical services for beneficiaries underage 21 in the Child Health Services (EPSDT) Program are not benefit limited.
Office medical services covered in the Visual Care Program are limited to the following procedure codes:
92002 |
92004 |
92012 |
92014 |
99201 |
99202 |
99203 |
99204 |
99205 |
99211 |
99212 |
99213 |
99214 |
99215 |