The Business of Contact Lenses - Takeaways - MDSpire

The Business of Contact Lenses

Discover the key requirements for referring patients for corneal cross-linking with riboflavin (CXL) and the challenges related to insurance coverage in specialty contact lens prescribing.

  • By

  • CLARKE D. NEWMAN, OD, FAAO

  • April 1, 2025

  • 5 min

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  • 1

    Corneal cross-linking (CXL) is a standard of care for keratoconus and ectasia, approved by the FDA since 2015.

  • 2

    Insurance reimbursement for CXL is often limited by the definition of medical necessity, requiring specific documentation.

  • 3

    Patients must meet criteria including age, corneal thickness, and visual acuity to qualify for CXL.

  • 4

    Contraindications for CXL include corneal scarring, severe ocular surface disease, and certain infections.

  • 5

    Practitioners should confirm diagnosis and contraindications before referring patients for CXL and advise on potential insurance coverage gaps.

Original Source(s)

The Business of Contact Lenses

  • by CLARKE D. NEWMAN, OD, FAAO

  • April 1, 2025

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