Washington Administrative Code
Title 182 - Health Care Authority
WASHINGTON APPLE HEALTH
Chapter 182-544 - Vision care
VISION CARE - CLIENTS TWENTY YEARS OF AGE AND YOUNGER
Section 182-544-0010 - Vision care - General

(1) The medicaid agency covers the vision care services listed in this chapter for clients age twenty and younger, according to agency rules and subject to the limitations and requirements in this chapter. The agency pays for vision care when it is:

(2) The agency does not require prior authorization for covered vision care services that meet the clinical criteria set forth in this chapter.

(3) The agency requires prior authorization for covered vision care services when the clinical criteria set forth in this chapter are not met, including the criteria associated with the expedited prior authorization process.

(4) The agency evaluates requests for covered services that do not meet clinical criteria based on the definition of medical necessity in WAC 182-500-0070 and the process in WAC 182-501-0165.