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2412.15.00 PAYMENT FOR EYE EXAMINATION (MED 1) The policy stated in this section only applies to the MA B and MA R categories of assistance. The maximum payment for an eye examination necessary to establish initial or continuing eligibility for MA is $29.56 The maximum payment for completion of an eye report based on a previous examination for which the doctor has already been paid is $10.57

Providers should be referred to www.in.gov/Medicaid for procedures to submit claims for payment on Medicaid Blind exams or submission of medical records.

2412.15.05 EYE EXAMINATION REQUIREMENT FOR REAPPLICATIONS (MED 1) The policy stated in this section only applies to the MA B and MA R categories of assistance. The guidelines enumerated below are to be followed for reapplications: • If receipt of SSI based on blindness is verified as explained in Section 2412.10, the blindness requirement is met. • If the date previously established by the MMRT for a re-examination of eyesight is in the future, or the MMRT waived further eye examinations in its previous determination, the visual requirement is met. • Any future eye examination must be completed for continuing eligibility.58 • If the eligibility worker is aware that the applicant had vision restorative eye surgery since the last eye examination in the case, a current eye report is to be submitted to the MMRT.

2412.15.10 INABILITY TO OBTAIN EYE REPORT (MED 1) The policy stated in this section only applies to the MA B and MA R categories of assistance.

In no instance is an application to be denied solely because the eye doctor did not return Form 45 to the Local Office if the applicant is still interested in pursuing his application. As it is the joint responsibility of the applicant and the caseworker to make every effort to obtain visual information, caseworkers must monitor a pending application closely for receipt of the visual information in accordance with the following guidelines: