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The Pennsylvania Code website reflects the Pennsylvania Code changes effective through 54 Pa.B. 488 (January 27, 2024).

55 Pa. Code § 1147.51. General payment policy.


§ 1147.51. General payment policy.

 Payment is made for covered services provided by participating optometrists subject to the conditions and limitations established in this section and § §  1147.53 and 1147.54 (relating to limitations on payment; and noncompensable services and items), and Chapters 1101 and 1150 (relating to general provisions; and MA Program payment policies) and the MA Program fee schedule. Payment will not be made for a compensable optometric service if payment is available from another public agency or another insurance or health program. Optometric services shall be billed in the name of the optometrist providing the service.


   The provisions of this §  1147.51 adopted January 25, 1980, effective February 1, 1980, 10 Pa.B. 264; amended April 25, 1980, effective May 7, 1980, 10 Pa.B. 3796; reserved amended December 23, 1983, effective January 1, 1983, 13 Pa.B. 3932; corrected March 30, 1984, effective November 14, 1981, 14 Pa.B. 1089; amended September 30, 1988, effective October 1, 1988, 18 Pa.B. 4418. Immediately preceding text appears at serial page (117394).

Cross References

   This section cited in 55 Pa. Code §  1147.12 (relating to outpatient services); and 55 Pa. Code §  1147.13 (relating to inpatient services).

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