MedicaidCoverageMedium impact
MSA 16-31
Michigan Medicaid - MDHHS·MI · Optometry, Ophthalmology·Provider Bulletin
Effective date
Nov 1, 2016
We identified it
Jun 20, 2026
Summary
Michigan Medicaid updated eyeglass repair and replacement policies, distinguishing between major repairs (separately reimbursed) and minor repairs (not reimbursed), with new guarantee requirements and prior authorization rules for replacement limits.
Action Required
By November 1, 2016: Vision providers must implement new repair classification system - bill only major repairs (lens reinsertion, screw repair, temple replacement) using appropriate HCPCS codes, stop billing minor repairs (screw insertion, adjustments). Document repair reasons in patient files. Guarantee repairs for 30 days and return reimbursement if replacement needed within 30 days. Obtain prior authorization for eyeglass replacements exceeding limits.