SECTION 61.23. Program Benefits

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(a) Scope of services.
(1) Reimbursement will be limited to a maximum of $60 per examination for a complete dilated funduscopic examination on both eyes.
(2) These examinations will also include acuity testing, tonometry, and assessment of lens opacity.
(b) Maximum allowable benefits. Maximum allowable benefits per client per year are limited to one annual screening examination. In instances where eye disease (retinopathy, maculopathy) is detected in the initial exam, a maximum of two additional follow-up exams may be administered within any given twelve month period if needed, unless written approval is obtained from the DEDP.
(c) Funding limitations. Payment will not be made for any diagnostic test, corrective lenses, or treatment of eye disease.

Source Note: The provisions of this §61.23 adopted to be effective July 23, 1990, 15 TexReg 3853; amended to be effective July 25, 2004, 29 TexReg 6905

                    
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