Commonwealth of Massachusetts
MassHealth
Provider Manual Series
Subchapter Number and Title
Table of Contents
Page
vi
Vision Care Manual
Transmittal Letter
VIS-41
Date
07/01/12

6.  Service Codes and Descriptions

Introduction							6-1
Definitions							6-1
Explanation of Abbreviations 					6-2
Service Codes and Descriptions:  Visual Analysis 		6-2
Service Codes and Descriptions:  Supplementary Testing 		6-9
Service Codes and Descriptions:  Contact Lenses 		6-10
Service Codes and Descriptions:  Contact Lens Services 		6-11
Service Codes and Descriptions:  Dispensing of Ophthalmic 
Materials: Fitting of  Prescription Spectacles, 
Glass/Plastic Lenses 						6-11
Service Codes and Descriptions:  Dispensing of Ophthalmic 
Materials: Repairs and  Replacement Parts 			6-11
Service Codes and Descriptions:  Miscellaneous 			6-12

Appendix A.	Directory 					A-1
Appendix B.	Enrollment Centers				B-1
Appendix C.	Third-Party-Liability Codes 			C-1
Appendix U.	DPH-Designated Serious Reportable Events 
		That Are Not Provider Preventable Conditions 	U-1
Appendix V.	MassHealth Billing Instructions for Provider 
		Preventable Conditions 				V-1
Appendix W.	EPSDT Services:  Medical and Dental Protocols 
		and Periodicity Schedules			W-1
Appendix X.	Family Assistance Copayments and Deductibles 	X-1
Appendix Y.	EVS Codes/Messages 				Y-1
Appendix Z.	EPSDT/PPHSD Screening Services Codes 		Z-1