Code of Maryland Regulations
Title 10 - MARYLAND DEPARTMENT OF HEALTH
Part 2
Subtitle 09 - MEDICAL CARE PROGRAMS
Chapter 10.09.14 - Vision Care Services
Section 10.09.14.05 - Limitations

Universal Citation: MD Code Reg 10.09.14.05

Current through Register Vol. 51, No. 19, September 20, 2024

A. The following are not covered:

(1) Eyeglasses, ophthalmic lenses, optical aids, and optician services rendered to recipients 21 years old and older;

(2) Eyeglasses, ophthalmic lenses, optical aids, and optician services rendered to recipients which were not ordered as a result of a full or partial EPSDT screen;

(3) Repairs, except when repairs to eyeglasses are more cost-effective than replacing with new eyeglasses;

(4) Combination or metal frames except when required for proper fit;

(5) Cost of travel by the provider;

(6) A general screening of a Medical Assistance population;

(7) Visual training sessions which do not include orthoptic treatment;

(8) Routine adjustment.

B. An optometrist certified by the Board as qualified to administer diagnostic pharmaceutical agents may use the following agents in strengths not greater than the strengths indicated:

(1) Agents directly or indirectly affecting the pupil of the eye, including the mydriatics and cycloplegics listed below:
(a) Phenylephrine hydrochloride (2.5 percent);

(b) Hydroxyamphetamine hydrobromide (1 percent);

(c) Cyclopentolate hydrochloride (0.5-2 percent);

(d) Tropicamide (0.5 and 1 percent);

(e) Cyclopentolate hydrochloride (0.2 percent) with Phenylephrine hydrochloride (1 percent);

(f) Dapiprazole hydrochloride (0.5 percent); and

(g) Hydroxyamphetamine hydrobromide (1 percent) and Tropicamide (0.25 percent); and

(2) Agents directly or indirectly affecting the sensitivity of the cornea including the:
(a) Topical anesthetics listed below:
(i) Proparacaine hydrochloride (0.5 percent); and

(ii) Tetracaine hydrochloride (0.5 percent); and

(b) Diagnostic topical anesthetic and dye combinations listed below:
(i) Benoxinate hydrochloride (0.4 percent) - Fluorescein sodium (0.25 percent); and

(ii) Proparacaine hydrochloride (0.5 percent) - Fluorescein sodium (0.25 percent).

C. An optometrist certified by the Board as qualified to administer and prescribe topical therapeutic pharmaceutical agents is limited to:

(1) Ocular antihistamines, decongestants, and combinations of them, excluding steroids;

(2) Ocular antiallergy pharmaceutical agents;

(3) Ocular antibiotics and combinations of ocular antibiotics, excluding specially formulated or fortified antibiotics;

(4) Anti-inflammatory agents, excluding steroids;

(5) Ocular lubricants and artificial tears;

(6) Tropicamide;

(7) Homatropine;

(8) Nonprescription drugs that are commercially available; and

(9) Primary open-angle glaucoma medications, in accordance with a written treatment plan developed jointly between the optometrist and an ophthalmologist.

Disclaimer: These regulations may not be the most recent version. Maryland may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.