Cataract Surgery

Medicare covers cataract (lens extraction) in adults when lens opacity causes symptomatic visual impairment not correctable with tolerable nonoperative measures or when cataract prevents monitoring/treatment of concomitant intraocular disease, threatens ocular health (e.g., lens‑induced glaucoma), or is required for other ocular procedures. Elective refractive lens exchange is not covered, and Medicare limits coverage to standard non‑correcting prosthetic intraocular lenses; documentation must include a preoperative evaluation (visual acuity in context, slit lamp or red reflex assessment) that substantiates medical necessity.

"Cataract causing symptomatic visual impairment not correctable with a tolerable change in glasses or contact lenses, lighting, or non‑operative measures, resulting in activity limitations or partic..."

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