Ocularists Assigned DMEPOS Specialty Code

Effective January 1, 2011, ocularists will be identified under specialty code B5 when submitting DMEPOS claims for reimbursement to Medicare. A Medicare supplier identification number will be required.

An ocularist is defined as a “carefully trained technician skilled in the arts of fitting, shaping, and painting ocular prostheses.” Ocularists create prostheses and train patients in the handling and care of ocular prostheses, as well as provide periodic examinations over time to assess the fit and condition of the device. Some of these services may be reimbursed by insurance in addition to Medicare.

Those being referred to an ocularist may require a written prescription from the referring eye care specialist to comply with coverage requirements; Medicare will require a physician’s order. It is not known at this time what, if any, supervision requirements will be if the ocularist is part of a physician’s practice.