Mississippi Administrative Code
Title 23 - Division of Medicaid
Part 217 - Vision Services
Chapter 1 - General
Rule 23-217-1.4 - Non-Covered Services

Universal Citation: MS Code of Rules 23-217-1.4

Current through September 24, 2024

A. The Division of Medicaid does not cover vision services including, but not limited to, eye exams, eyeglasses, frames, lenses, and/or contact lenses, for beneficiaries enrolled in the Family Planning Waiver (FPW).

B. The Division of Medicaid does not cover the following including, but not limited to:

1. Eyeglasses solely for protective, fashion, cosmetic, sports, occupational or vocational purposes,

2. More than one (1) pair of eyeglasses every five (5) years,

3. Single vision eyeglasses in addition to multifocal eyeglasses,

4. Progressive bifocals,

5. Sunglasses,

6. Upgraded frames,

7. Eyeglass cases,

8. Engraving,

9. Contact lens supplies and/or solutions,

10. Eyeglass or contact lens insurance,

11. Lens coating, unless specified by a Utilization Management/Quality Improvement Organization (UM/QIO), the Division of Medicaid, or designated entity,

12. Orthoptics,

13. Dispensing fees,

14. Contact lenses, unless specified by a UM/QIO, the Division of Medicaid, or designated entity,

15. Refractive surgery including, but not limited to, Lasik surgery, radial keratotomy, photorefractive keratectomy, and/or astigmatic keratotomy,

16. Services and items requiring prior authorization for which authorization has been either denied or not requested, or

17. Replacement of lenses or frames due to:
a Provider error in prescribing, frame selection, or measurement, or

b Poor workmanship and/or materials.

42 CFR §§ 435.116, 441.30; Miss. Code Ann. §§ 43-13-117, 43-13-121; SPA 13-0019; Healthier Mississippi Waiver.

Disclaimer: These regulations may not be the most recent version. Mississippi 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.
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