Critical FQHC Compliance Fact: Eyeglasses Are NOT In HRSA Scope — Excluded from Sliding-Fee Mandate, NOT PPS-Encounter-Billable

Per HRSA Health Center Program Compliance FAQs and Compliance Manual Chapter 4: 'eyeglasses, hearing aids, and dentures' are explicitly excluded from in-scope services. Critical operational implications for FQHC vision programs: (1) Eyewear sales are NOT encounter-rate billable to PPS — only the OD exam visit is.

(2) Eyeglasses are NOT subject to the HRSA sliding-fee discount mandate — FQHCs may set pricing flexibly. (3) HRSA grant funds CANNOT be used for eyewear inventory. (4) Optical dispensary is operationally a patient-experience amenity, not a PPS revenue line.

The optometry exam itself is where the FQHC vision program makes its money — that's the PPS encounter for the visit. Many FQHC executives assume the PPS umbrella covers eyewear — it doesn't.

This affects budgeting, pricing flexibility, and HRSA compliance reviews. NACHC notes vision is also non-mandatory under HRSA Section 330 — base grants cannot launch new vision lines, must come from expansion grants, 340B savings, or operating capital.