Intraocular Lens (IOL) Implants 9.01.14
Policy 9.01.14 considers a monofocal intraocular lens, spherical or aspheric, medically appropriate to replace the natural lens after cataract extraction. It considers multifocal, astigmatism-correcting (toric monofocal) and accommodating or trifocal IOLs not medically necessary, because no superior medical benefit has been demonstrated over the monofocal IOL other than decreasing the need for corrective eye wear. When individuals choose a toric, multifocal or accommodating lens, reimbursement is provided only for the cost of a standard or monofocal IOL. The current effective date is October 22, 2026, and the 10/22/26 annual review left the policy intent unchanged.