Dispensing, Fitting and Repair of Glasses
(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 client 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 patient’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 client prior to dispensing; or
(b)Client failure to pick up ordered glasses. Documentation in the client’s record must show that the provider made serious efforts to contact the client.
(5)Providers must keep a copy of the delivery invoice included with all parts orders in the client’s records or document the delivery invoice number in the client’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.
Rule 410-140-0200 — Dispensing, Fitting and Repair of Glasses,