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Insured Optometric Services Tariff Regulations

made under clause 13(1)(c) and subsection 17(2) of the

Health Services and Insurance Act

R.S.N.S. 1989, c. 197

O.I.C. 2002-255 (May 3, 2002, effective April 1, 2001), N.S. Reg. 68/2002

as amended by O.I.C. 2010-279 (July 13, 2010), N.S. Reg. 107/2010


Citation

1     These regulations may be cited as the Insured Optometric Services Tariff Regulations.


Insured optometric services

2     The insured optometric services are as set out in the following table:


Health

Service

Code

Description

Conditions for Coverage

Insured Ages

Frequency

Medical

Service

Units

09.02C

Full exam - routine

 

0-9 years and 65 years and over

1 per every

2-year period

20.48

09.02C

Full exam - non routine

Medical necessity

Any age

1 per year

20.48

3.03

Continuing care

Medical necessity

Any age

1 per year

11

3.03

Continuing care - specific diagnosis

Where eye pathology has been identified or suspected


In conjunction with a noted differential diagnosis or prescribed medication only and not an over-the-counter product


Must be submitted with supporting text, details of which are found in the Department of Health and Wellness ’s Optometric Services Manual

Any age

6 per year

11

22.69A

Punctual occlusion

Where eye pathology has been identified or suspected and where other therapies have been tried


Only for insertion of permanent plugs and not for materials


Not for contact lens-related dry eye

Any age

1 per eye per lifetime

22 for 1 eye, and 33 for both eyes

21.31

Dilation of lacrimal punctum

Where eye pathology has been identified or suspected and where other therapies have

been tried

True epiphora

Positive Jones Test

Patient must not have ectropion

Any age

1 per eye per lifetime

30 for 1 eye, and 45 for both eyes

[Note: the reference to the Department of Health has been updated in accordance with Order in Council 2011-15 under the Public Service Act, R.S.N.S. 1989, c. 376, effective January 11, 2011.]


Tariff of fees

3     The tariff of fees for insured optometric services is as follows:

 

                (a)    effective on and after the date this Section comes into force, the Medical Services Unit (MSU) is $2.65; and

 

                (b)    effective April 1, 2011, the MSU is increased to $2.68.

Section 3 replaced: O.I.C. 2010-278, N.S. Reg. 107/2010.