MedicaidPrior AuthMedium impact
Change in Billing Policy for Contact Lens Prescription and Fitting Service
Illinois Medicaid - HFS·IL · Optometry, Ophthalmology·Provider Notice
Effective date
Jan 22, 2008
We identified it
Jun 21, 2026
Summary
Illinois Medicaid has removed previous limitations on CPT code 92310 (contact lens prescription and fitting service) and will now accept prior approval requests when providers deem it medically necessary. The service must still meet CPT criteria and providers are reminded to obtain and report their NPIs.
Action Required
Immediately: Billing team should update prior authorization procedures to allow requests for CPT 92310 contact lens prescription and fitting services when medically necessary for Illinois Medicaid patients. Ensure all providers and payees have obtained and reported their NPIs to the Illinois Department of Healthcare and Family Services.