MEDICARE COVERAGE OF GLAUCOMA SCREENING

1. MEDICARE COVERAGE OF GLAUCOMA SCREENING

2. The Benefits Improvement and Protection Act of 2000 • Medicare Covers Glaucoma Screening for Individuals With • Diabetes • A family history of glaucoma, or • A determined “high” risk for glaucoma

3. Effective Date • This Benefit is Effective for Services Furnished on or After January 1, 2002

4. People with Medicare who Qualify Include: • Individuals with diabetes mellitus • diet-controlled diabetes • oral-agent controlled diabetes • insulin dependent diabetes • Individuals with a family history of glaucoma • African Americans who are age 50 and over and eligible for Medicare Part B

5. Determination of High Risk • Baltimore Eye Study • Beaver Dam Study

6. Medicare Covers • A dilated eye exam with an intraocular pressure measurement • A Visual Acuity Test, and • A direct ophthalmoscopy or a slit-lamp biomicroscopic examination

7. This New Coverage Allows Payment for One Glaucoma Screening Examination Every Year

8. Who Can Perform the Tests? • Medicare covers test furnished by or under the direct supervision of • Optometrists, or • Ophthalmologists

9. Medicare Pays • Medicare will pay 80% after the Part B deductible has been met

10. Medicare Bundles Payment for Glaucoma Screening When • It is provided on the same day as regular evaluation and management services,or • it is provided as part of any ophthalmology services

11. Additional Services • optic nerve scanning • visual fields, and • dilated eye exams