Oregon Administrative Rules
Chapter 410 - OREGON HEALTH AUTHORITY, HEALTH SYSTEMS DIVISION: MEDICAL ASSISTANCE PROGRAMS
Division 140 - VISUAL SERVICES
Section 410-140-0200 - Dispensing, Fitting and Repair of Glasses

Universal Citation: OR Admin Rules 410-140-0200

Current through Register Vol. 63, No. 9, September 1, 2024

(1) The Division covers the fitting of glasses and the refitting and repair of glasses only when glasses and replacement parts are purchased from:

(a) The Division's contractor;

(b) Any visual materials supplier when the member has primary Medicare coverage and the glasses were a Medicare-covered benefit.

(2) Fitting of glasses for:

(a) Eligible adults (age 21 years and older) is limited to once every 24 months, except when dispensing glasses within 120 days of cataract surgery;

(b) Eligible children (birth through age 20) only when documented in the member's record as medically necessary.

(3) Periodic adjustment of frames and tightening of screws is included in the dispensing fee and is not separately reimbursed.

(4) The Division accepts either the date of order or date of dispensing as the date of service on claims. Glasses must be dispensed prior to billing the Division, except under the following conditions:

(a) Death of the member prior to dispensing; or

(b) Member failure to pick up ordered glasses. Documentation in the member's record must show that the provider made serious efforts to contact the member.

(5) Providers must keep a copy of the delivery invoice included with all parts orders in the member's records or document the delivery invoice number in the member's records for all repair and refitting claims.

(6) Fitting of spectacle mounted low vision aids, single element systems, telescopic or other compound lens systems are not covered.

(7) All frames have a limited warranty. Check specific frame styles for time limits. All defective frames must be returned to the contractor.

Tables referenced are not included in rule text. Click here for PDF copy of table(s).

Statutory/Other Authority: ORS 413.042

Statutes/Other Implemented: ORS 414.025 & 414.065

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