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(a) The department will pay an enrolled provider for vision services, including a vision examination, rendered to a recipient in accordance with 7 AAC 43.040. The department will calculate maximum allowable rates for covered services by using the factors and formula described in 7 AAC 43.108. The descriptions and billing codes for these procedures are provided in the United States Department of Health and Human Services, Centers for Medicare and Medicaid Services's (CMS) Healthcare Common Procedure Coding System (HCPCS) 2005, as amended from time to time, and adopted by reference.
(b) If eyeglasses are dispensed by mail, the department will pay an additional $6 to cover the cost of sending the eyeglasses by insured mail.
(c) The department will pay an enrolled provider $80 for dispensing and fitting contact lenses.
(d) The department will reimburse an enrolled provider $30 for dispensing and fitting eyeglasses.
(e) The department will reimburse an enrolled provider $10 for eyeglass frame repair.
History: Eff. 9/1/94, Register 131; am 2/1/97, Register 141; am 10/12/97, Register 144; am 12/4/97, Register 144; am 6/26/98, Register 146; am 5/5/99, Register 150; am 6/24/2004, Register 170; am 9/29/2005, Register 175
Authority: AS 47.05.010
Editor's note: The payment rates for vision services calculated under 7 AAC 43.108 appear in Table I-4 of the vision services section of the Alaska Medicaid Provider Billing Manual, which may be obtained by contacting the Department of Health and Social Services, Division of Health Care Services, P.O. Box 110601, Juneau, Alaska 99811-0601; Internet site: http://www.hss.state.ak.us/dhcs/.
The United States Department of Health and Human Services, Centers for Medicare and Medicaid Services's (CMS) Healthcare Common Procedure Coding System (HCPCS) 2005, adopted by reference in 7 AAC 43.642, may be obtained by contacting the Superintendent of Documents, United States Government Printing Office, Washington, D.C. 20402. A copy of the HCPCS is available for examination at the Department of Health and Social Services, Division of Health Care Services, 350 Main St., Juneau, Alaska 99801.
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Last modified 7/05/2006