Code of Massachusetts Regulations
130 CMR - DIVISION OF MEDICAL ASSISTANCE
Title 130 CMR 402.000 - Vision Care Services
Section 402.428 - Service Limitations: Replacement Eyeglasses
Current through Register 1531, September 27, 2024
(A) Broken Eyeglasses. The MassHealth agency pays for the repair of broken eyeglasses, including the replacement of broken parts, subject to the following limitations.
(B) Lost Eyeglasses (Child). The MassHealth agency pays for the replacement of lost or stolen eyeglasses within the preceding 12 months of the previous eyeglass dispensing for members younger than 21 years old without PA.
(C) Lost Eyeglasses (Adult). The MassHealth agency pays for one replacement of lost or stolen eyeglasses within the preceding 24 months for members 21 years of age or older without PA. Subsequent replacement of a pair of lost or stolen eyeglasses within the 24-month period requires prior authorization.
(D) Prescription Changes. The MassHealth agency pays for new eyeglasses with a different prescription prior to the standard frequency service limitation at 130 CMR 402.427, only if there is a change from the current prescription of at least +.50D sphere or cylinder; or an axis change of at least 3º for a +1.00D cylinder or over, 5º for a +.75D cylinder, or 10º for a +.50D cylinder. Prior authorization is not required.
(E) Plano. MassHealth pays for a plano lens (no correction required) for a member who is Monocular. Prior authorization is not required.
(F) Appropriate Service Codes. The appropriate service codes (see Subchapter 6 of the Vision Care Manual) must be used when submitting claims for dispensing replacement frames or parts of frames.