Medicare and Vision Rehabilitation

Did you know that prior to 2020  Medicare didn’t cover acupuncture for lower back pain? Often the only alternative was an addictive pain killer. Before 2009, Certified Midwives were not covered by Medicare. If you needed a chiropractor before 1974, you paid for it out of pocket, because chiropractic services were not covered by Medicare.

What does this have to do with Vision Rehabilitation? The point is that Medicare doesn’t always get it right, right away!

According to the American Academy of Ophthalmology, “Provision of, or referral to, vision rehabilitation is now the standard of care for all who experience vision loss.” In spite of this, right now, Medicare doesn’t cover the most highly trained, nationally certified professionals in the field of vision rehabilitation–the Vision Rehabilitation Therapist, and the Orientation and Mobility Specialist. In both professions, these specialists hold a Master’s Degree in their field, and in most cases a national certification.

Medicare does, however, reimburse the occupational therapist for some vision rehabilitation services. OTs rarely have a specialty certification in vision rehabilitation, and often have very little academic training in vision rehabilitation. The OT is a medical generalist. So, in  practical terms, what this means is that Medicare will reimburse an occupational therapist, for vision rehabilitation services even if her medical experience has only been infants and children. while at the same time denying an O&M Specialist or Certified Vision Rehabilitation Therapist with a Master’s Degree and national certification in vision rehabilitation.

As a result, this can make it difficult to find the most qualified vision rehabilitation professionals, because the doctor’s practice may choose to hire OTs with far less experience in vision rehab because they can bill Medicare. So they may not  even refer patients to the O&M or VRT who most likely works in a state or local agency that provides services for clients with a vision loss.

And let’s not forget that it’s often the case that the Vision Rehabilitaiton Therapist and Orientation and Mobility Specialist provide their services at little to no cost to clients, because they usually work through a state or locale non-profit. So you may actually pay much less for the more highly trained professional.

If you want one of the most qualified vision rehabilitation professionals, ask your doctor for a referral to a certified vision rehabilitation therapist, or orientation and mobility specialist. If you’re referred to an OT, ask if they have a any training or certification in low vision rehabilitation.

If you need help finding a certified vision rehabilitation therapist or orientation and mobility specialist, call the APH Connect Cebter at 800-232-5463 or use the Connect Center’s online Direcctory of Services where you can search for your state at aphconnectcenter.org/directory.

If you’d like to encourage Medicare to get this one right sooner than later, give them a call at the Center for Medicare Service at 877-267-2323 and ask when vision rehabilitation therapists and orientation and mobility specialists will be covered under Madicare.