Section 15. Noncovered Services

The following services are subject to the limitations and coverage restrictions that exist for other MAD services; see 8.302.1 NMAC and 8.310.2 NMAC. The provider must notify the MAP eligible recipient of the coverage limitations prior to providing services. A. Vision appliances: MAD does not cover the following specific vision services: (1) orthoptic assessment and treatment; (2) photographic procedures, such as fundus or retinal photography and external ocular photography; (3) polycarbonate lenses other than those listed in Subsection A of Section 13 of this part; (4) ultraviolet (UV) lenses; (5) trifocals; (6) progressive lenses; (7) tinted or photochromic lenses, except in cases of documented medical necessity; see Subsection D of Section 12 of this part; (8) oversize frames and oversize lenses; (9) low vision aids; 8.324.5 NMAC 11 (10) eyeglass cases; (11) eyeglass or contact lens insurance; and (12) anti-scratch, anti-reflective, or mirror coating. B. Hearing appliances: Hearing aid selection and fitting is considered included in the hearing aid dispensing fee, and will not be reimbursed separately. C. DME, oxygen and medical supplies: MAD does not cover certain DME and medical supplies. See 8.301.3 NMAC for an overview of which DME or supply item is not covered by MAD. D. Prosthetic and orthotics: The following services are not covered: (1) orthotic supports for the arch or other supportive devices for the foot, unless they are integral parts of a leg brace or therapeutic shoes furnished to diabetics; and (2) prosthetic devices or implants that are used primarily for cosmetic purposes.