1. (a) Each single service HMO evidence of coverage providing vision care services and benefits shall provide the following as covered primary and preventive vision services: comprehensive eye examination to include medical history; visual acuities, with correction (distance and near), without correction (distance and near); cover test at 20 feet and at 16 inches; versions; external examination of the eye lids, cornea, conjunctiva, pupillary reaction (neurological integrity) and muscle function; binocular measurements for far and near; internal eye examination (ophthalmoscopy); autorefraction/refraction (far point and near point); tonometry (reasonable attempt or equivalent testing if contraindicated); retinoscopy; biomicroscopy; intraocular pressure-glaucoma test; slit lamp examination; and urgent care as defined in §11.2 of this title (relating to Definitions).
2. (b) A single service HMO evidence of coverage providing vision care services and benefits may provide coverage for secondary vision care services which include contact lens examination; fitting; training; follow-up visits, or eye glasses.

Source Note:The provisions of this §11.2204 adopted to be effective November 2, 1998, 23 TexReg 11347; amended to be effective February 24, 2005, 30 TexReg 854.