CMS Pub. 100-03, ch. 1, § 80.1

Some hydrophilic contact lenses are used as moist corneal bandages for the treatment of

acute or chronic corneal pathology, such as bulbous keratopathy, dry eyes, corneal ulcers

and erosion, keratitis, corneal edema, descemetocele, corneal ectasis, Mooren’s ulcer,

anterior corneal dystrophy, neurotrophic keratoconjunctivitis, and for other therapeutic

reasons.

Payment may be made under §1861(s)(2) of the Social Security Act for a hydrophilic

contact lens approved by the Food and Drug Administration (FDA) and used as a supply

incident to a physician’s service. Payment for the lens is included in the payment for the

physician’s service to which the lens is incident. A/B MACs are authorized to accept an

FDA letter of approval or other FDA published material as evidence of FDA approval.

(See §80.4 for coverage of a hydrophilic contact lens as a prosthetic device.) See the

Medicare Benefit Policy Manual, Chapter 15, “Covered Medical and Other Health

Services,” and the Medicare Benefit Policy Manual, Chapter 6, “Hospital Services

Covered Under Part B,” §20.4.