Pennsylvania Code
Title 55 - HUMAN SERVICES
Part III - MEDICAL ASSISTANCE MANUAL
Chapter 1123 - MEDICAL SUPPLIES
PAYMENT FOR MEDICAL SUPPLIES
Section 1123.56 - Vision aids

Universal Citation: 55 PA Code ยง 1123.56

Current through Register Vol. 54, No. 44, November 2, 2024

(a) Payment for eyeglasses is made only if the recipient is 20 years of age or younger and the eyeglasses have been one of the following:

(1) Prescribed through EPSDT program as described in § 1101.32(a)(1) (relating to coverage variations).

(2) Prior authorized by the Department as provided through EPSDT, when screening has not occurred under § 1101.32(a)(1).

(3) Prescribed through the School Medical Program as described in § 1101.32(a)(2).

(b) Payment for low vision aids is made only if the recipient is categorically needy or if the recipient is medically needy and the low vision aid has been one of the following:

(1) Prescribed through EPSDT program as described in § 1101.32(a)(1).

(2) Prior authorized by the Department as provided through EPSDT when screening has not occurred under § 1101.32(a)(1).

(3) Prescribed through the School Medical Program as described in § 1101.32(a)(2).

(c) Payment for eye protheses will be made only if the recipient is categorically needy.

This section cited in 55 Pa. Code § 1123.22 (relating to scope of benefits for the medically needy); and 55 Pa. Code § 1123.52 (relating to payment conditions for various services).

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