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Vision Care

Methodology / Rules

The Vision Care program rules are located at Title 1 of the Texas Administrative Code, Part 15, Chapter 354, SubChapter A, Division 2, Rules 1015, 1017, 1021, 1023, and 1025.

Reimbursement rules applicable to Vision Care are located at Title 1 of the Texas Administrative Code, Part 15, Chapter 355, SubChapter J, Division 1, Rule 8001; Division 5, Rules 8081; and Division 24, Rule 8461.

The fee schedules and any periodic adjustment(s) to the fee schedules are published in banner messages contained in provider Remittance and Status (R&S) reports, Medicaid Bulletin articles, web postings, provider manual, fee schedules or other provider notification.

Payment Rate Information

Payment rate information is published by procedure code in the applicable Texas Medicaid Fee Schedule located on the Texas Medicaid & Healthcare Partnership (TMHP) website (see Fee Schedules).