Code of Massachusetts Regulations
130 CMR - DIVISION OF MEDICAL ASSISTANCE
Title 130 CMR 402.000 - Vision Care Services
Section 402.429 - Service Limitations: Tinted Lenses
Universal Citation: 130 MA Code of Regs 130.402
Current through Register 1531, September 27, 2024
(A) The MassHealth agency pays for "pink l" and "pink 2" colored lenses, up to 25% absorption or equal-density tint, if at least one of the following conditions applies:
(1) the member has a pathological or other
abnormal condition such as aphakia; or
(2) the member has habitually worn tinted
lenses of this nature, and the prescriber concludes that the member should
continue to wear them. The MassHealth agency does not pay for tinted lenses
prescribed only because the member complains of photophobia.
(B) Any condition that warrants the use of tinted lenses must be fully documented in the member's medical record.
(C) In some situations, other tints (available for plastic lenses only) may be medically justified. Any condition that warrants the use of tinted lenses of this nature must be fully documented in the member's medical record, and may be ordered from the optical supplier only after the provider has received prior authorization from the MassHealth agency.
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