1 TAC § 354.1023. Optometric Services Provider, DIVISION 2. MEDICAID VISION CARE PROGRAM

(a) In addition to those services described in §354.1015 and §363.502 of this title (both relating to Benefits and Limitations), and subject to the specifications, conditions, limitations, and requirements established by the Texas Health and Human Services Commission (HHSC) or its designee, diagnostic and treatment services performed by a provider qualified to provide optometric services under Texas Medicaid are covered by the Texas Medicaid Program.

(b) To be covered, the evaluation, diagnostic, and treatment services must be:

(1) within the provider's scope of practice, as defined by state law;

(2) reasonable and medically necessary as determined by HHSC; and

(3) provided to an eligible recipient by a qualified provider enrolled in the Texas Medicaid Program at the time the service(s) are provided.