Optometry Coding & Billing Alert

Not every Medicare beneficiary can receive low-vision services - here's how to find out who can

Medicare will pay for rehabilitation services provided by a physician, a qualified occupational therapist, or a qualified physical therapist. But beware: CMS has strict rules about who qualifies for rehab.

"The patient must have a potential of restoration or improvement of lost functions, and must be expected to improve significantly within a reasonable and generally predictable amount of time," says Medicare's policy for coverage of vision-impairment rehabilitation services.

Do this: Check your Medicare carrier for LMRPs or LCDs concerning low-vision therapy. Many carriers have policies similar to that of National Heritage Insurance Company of California, which limits low- vision rehabilitation to patients exhibiting one of the following: