HI 00620.200 Exclusion of Refractive Services

Expenses for all eye refraction procedures, whether performed by an opthalmologist (or any other physician) or by an optometrist and without regard to the reason for the performance of the refraction, are excluded from coverage under the program. Although payment can be made for the prosthetic lenses (e.g., following cataract surgery) and any incidental charges that may be assessed for the fitting thereof, no payment can be made in such cases for the procedures performed to determine the refractive state of the eye.

All of the services and procedures are excluded where an eye examination is performed for the purpose of prescribing, fitting, or changing eyeglasses without regard to whether these services are furnished by a physician or by another practitioner. (see HI 00620.110.).