MedicaidPrior AuthMedium impact
Clarification for Vision Service Authorization
Alaska Medicaid·AK · Optometry, Ophthalmology·Prior Authorization
Effective date
Nov 26, 2025
We identified it
Jun 21, 2026
Summary
Alaska Medicaid has clarified vision service authorization requirements and provided specific guidance on how to properly complete authorization requests. The policy specifies which vision products require prior authorization and requires providers to indicate the reason for authorization in box 16 of the form.
Action Required
Immediately: Billing team must update vision service authorization request procedures. In box 16 of the Vision Service Authorization Request Form, indicate whether authorization is for 'Product needing authorized', 'Override limit', or 'TPL Exhausted' along with diagnosis code and medical justification. For high index lenses, use only HCPCS codes V2782 or V2783 with LT/RT modifiers on separate lines. For TPL members, obtain EOB before requesting authorization and fax form with EOB to 888.772.3632. Requests using incorrect codes or missing required information will be denied.