Pennsylvania Code
Title 55 - HUMAN SERVICES
Part III - MEDICAL ASSISTANCE MANUAL
Chapter 1123 - MEDICAL SUPPLIES
PAYMENT FOR MEDICAL SUPPLIES
Section 1123.61 - Noncompensable services and items

(1) Items and services not listed in the Medical Assistance program fee schedule.

(2) Eyeglasses for individuals 21 years of age or older.

(3) Prescription sunglasses.

(4) Tinted lenses.

(5) Tennis shoes, sneakers, slippers, sandals or another type of footwear that does not fit the description of the orthopedic shoe or molded shoe established in § 1123.2 (relating to definitions).

(6) Surgical supplies and durable medical equipment for persons in skilled nursing and intermediate care facilities.

(7) Repairs or modifications to shoes other than orthopedic shoes as defined in § 1123.2 except for the insertion of orthotic devices.

(8) Orthotic devices for orthopedic or molded shoes.

(9) Items prescribed or ordered by a practitioner who has been barred or suspended during an administrative action from participation in the Medical Assistance Program. The Department will, periodically, send medical suppliers a list of names of suspended, terminated or reinstated practitioners and the dates of the various actions. Medical suppliers are responsible for checking this list before providing services.

(10) Orthopedic shoes for individuals 21 years of age or older.