Billing for Polycarbonate Lenses

Important Note

HMSA has partnered with EyeMed, service date effective January 1, 2022. HMSA transitioned our current vision portfolio to a new vision benefit with EyeMed for the following line of business: Commercial, Akamai Advantage®, QUEST Integration, Fed 87, and HMSA Plan for Postal Service Employees. HMSA will continue to be the administrators for non-routine vision services through the members medical plan(s). For more information, please contact EyeMed at: www.eyemedinfocus.com

Contact by phone

For Providers: 1-888-259-4344

Effective January 1, 2006, HMSA's Special Vision Plans will include benefits for polycarbonate lenses for children age 18 and younger. This additional benefit is subject to member eligibility at the time of service and plan limitations.

Claims Filing Information

Polycarbonate lenses may be billed as an add-on service. The table below indicates which HCPCS code should be used for each claim line item.

Example

The member has a prescription for glasses including single focal lenses at a specified strength. The provider will bill as follows:

Line 1 - V2101 x 2
Line 2 - V2784 x 2

Use of other codes when billing for polycarbonate lenses will result in denial of your claim.

Stand-Alone Benefit

To clarify, polycarbonate lenses are a stand-alone benefit that members may use whether or not they use their eye examination, contact lens, or eyeglasses benefits.

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