This is a clone of the Texas Administrative Code (TAC) for educational purposes. It is not the official version and should not be used for legal purposes. Site created Wed, 21 May 2025 21:16:49 GMT
(a) Each single service HMO evidence of coverage providing vision care services and benefits must provide the following as covered primary and preventive vision services:(1) comprehensive eye examination to include medical history;(2) visual acuities, with and without correction (distance and near);(3) cover test at 20 feet and at 16 inches;(4) versions;(5) external examination of the eye lids, cornea, conjunctiva, pupillary reaction (neurological integrity), and muscle function;(6) binocular measurements for far and near;(7) internal eye examination (ophthalmoscopy);(8) autorefraction/refraction (far point and near point);(9) tonometry (reasonable attempt or equivalent testing if contraindicated);(10) retinoscopy;(11) biomicroscopy;(12) intraocular pressure glaucoma test;(13) slit lamp examination; and(14) urgent care.(b) A single service HMO evidence of coverage providing vision care services and benefits may provide coverage for secondary vision care services, which include:(1) contact lens examination;(2) fitting;(3) training;(4) follow-up visits; or(5) eye glasses.