CMS Pub. 100-01, ch. 5, § 70.5

A. Services Furnished Through March 31, 1987

Prior to April 1, 1987, a doctor of optometry who was legally authorized to practice

optometry by the State in which he or she performed such a function was considered a

physician under Medicare, but only for the purpose of services related to the condition of

aphakia. Aphakia is defined as the absence of the natural crystalline lens of the eye,

whether or not an intraocular lens has been implanted. The services performed by

optometrists within this definition were subject to limitations set by the State relating to

the scope of practice of optometry.

The following are examples of examination services which were covered when furnished

by optometrists if related to the condition of aphakia: case history, external examination,

ophthalmoscopy, biomicroscopy, tonometry, visual fields, ocular motility, binocular

function, and evaluation for contact lenses, if the optometrist furnishing these services is

legally authorized to perform them.

B. Services Furnished After March 31, 1987

Effective April 1, 1987, a doctor of optometry is considered a physician with respect to

all services the optometrist is authorized to perform under State law or regulation. To be

covered under Medicare, the services must be medically reasonable and necessary for the

diagnosis or treatment of illness or injury, and must meet all applicable coverage

requirements. (See Benefit Policy Manual for information concerning exclusions from

coverage that apply to vision care services.)