Reimbursement of Therapeutic Bandage Contact Lenses

Most contact lenses (CLs) are designed to correct refractive errors.  A therapeutic CL is used as a bandage and to promote healing as in cases of ocular surface disease – providing good vision is not a significant consideration.

This FAQ addresses the following:

1. How do therapeutic contact lenses differ from other contact lenses?
2. Is fitting a therapeutic CL covered by Medicare and other third party payers?
3. How are the charges for a therapeutic fitting and the associated CL identified on a claim for reimbursement?
4. What is Medicare’s allowed amount for CPT code 92071?
5. Does Medicare limit how frequently this charge may be made?
6. May a therapeutic CL be provided by a technician when the physician is not present?
7. May any contact lens be used as a therapeutic CL?
8. Is payment made for therapeutic CLs dispensed in the post-operative period of surgery?

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