TITLE 89: SOCIAL SERVICES
CHAPTER I: DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES
SUBCHAPTER d: MEDICAL PROGRAMS
PART 140 MEDICAL PAYMENT
SECTION 140.416 OPTOMETRIC SERVICES AND MATERIALS


 

Section 140.416  Optometric Services and Materials

 

a)         Payment for optometric services and materials shall be made to physicians, optometrists, opticians and optical companies.

 

b)         Payment shall be made for the following optometric services and materials:

 

1)         An eye examination by a physician or an optometrist for the purpose of determining the condition of the eye including the refractive state.

 

2)         Frame repairs, contact lenses, artificial eyes and low vision devices provided by physicians, optometrists, opticians and optical companies.

 

3)         Dispensing of optical materials.

 

4)         Lenses, frame parts and frames provided by the Department of Corrections (DOC) laboratory.

 

c)         Optometric services and materials for which payment shall not be made include:

 

1)         Services which are not provided to address a recipient's particular visual problems or complaints.

 

2)         Lenses, frames and frame parts obtained from a source other than the DOC laboratory.

 

3)         Trifocals.

 

4)         Tinted lenses.

 

5)         Provider's transportation costs.

 

d)         Payment for services and materials shall be at the lesser of the provider's usual and customary charge or the maximums established by the Department pursuant to Section 140.400.

 

(Source:  Amended at 25 Ill. Reg. 6665, effective May 11, 2001)