MedicaidCoverageMedium impact
[Ohio] Versant Policy Updates September 2025
CareSource·OH · Ophthalmology, Optometry·Medical Policy
Effective date
Nov 1, 2025
We identified it
May 9, 2026
Summary
CareSource has partnered with Versant Health to update vision service policies for Ohio Medicaid members. Two policies—Medically Necessary Contact Lens (1309) and Specialty Spectacle Lens (1330)—are being updated effective November 1, 2025. Billing teams must review the full policy text at the Versant Health website to identify any changes to coverage criteria, billing requirements, or documentation standards.
Action Required
By October 15, 2025: Billing team must access the complete policy text for Policies 1309 and 1330 at https://superiorvision.com/legal/ under clinical policies. Review for changes to: (1) covered services and medical necessity criteria, (2) required prior authorization processes, (3) allowed billing codes and modifiers, and (4) documentation requirements. Update billing system edits, encounter templates, and provider education materials accordingly. Notify providers of any new prior authorization or documentation requirements before the November 1, 2025 effective date. This notification does not contain specific policy details—full policy review is mandatory to ensure compliant billing for Ohio Medicaid vision claims effective November 1, 2025.