US · guidance
CMS Pub. 100-03, ch. 1, § 80.4
Hydrophilic Contact Lenses
Hydrophilic contact lenses are eyeglasses within the meaning of the exclusion in
§1862(a)(7) of the Social Security Act and are not covered when used in the treatment of
non-diseased eyes with spherical ametrophia, refractive astigmatism, and/or corneal
astigmatism. Payment may be made under the prosthetic device benefit, however, for
hydrophilic contact lenses when prescribed for an aphakic patient.
A/B MACs are authorized to accept a Food and Drug Administration (FDA) letter of
approval or other FDA-published material as evidence of FDA approval. (See §80.1 for
coverage of a hydrophilic lens as a corneal bandage.)
Cross-references:
The Medicare Benefit Policy Manual, Chapter 15, “Covered Medical and Other Health
Services,” §100 and §120.
The Medicare Benefit Policy Manual, Chapter 16, “General Exclusions from Coverage,”
§20 and §90.
History
(Rev. 173, Issued: 09-04-14, Effective: Upon Implementation: of ICD-10, Implementation: Upon Implementation of ICD-10)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
2ffc27b390d58218aa5e463c5be48f4afb450b88b5496bd372bb1ffbdafb9292
The link goes to the issuing authority’s own document — the one we read to produce this record. Where a source publishes whole titles rather than sections, your browser may need a moment to jump to the provision.
Unofficial copy of government-published law, reproduced from official sources with full provenance. Not an official publication; verify against official sources before relying on it in a filing. Records in the 'guidance' corpus, and only that corpus, are sub-regulatory (interpretive guidelines, survey procedures) and are not binding law. Validity bounds follow each jurisdiction's declared temporalBasis.