Refractions: Bill patients, but not Medicare

Why This Topic Matters

Understanding this topic helps practices avoid incorrect Medicare billing, reduce patient disputes, and use the appropriate beneficiary communication process when a service is statutorily excluded from coverage.

Article Sections

1. Medicare noncoverage of refractions

   This section explains the overall Medicare coverage status of refraction services and discusses why the issue comes up in everyday practice. It also places the topic in the context of cataract surgery and patient billing.

2. Patient education and claim handling

   This section addresses how practices may communicate the coverage issue to patients and how claims may be handled when patients want a Medicare denial on file. It also notes the use of beneficiary notices and related documentation tools.