The following is a partial list of examination codes and fees for the more common eye examinations performed in our office. The fee(s) listed will normally be billed to your medical or vision insurance plan, depending on the reason for the visit. If you are seen by an optometrist for an eyeglass evaluation (“refraction”) and an ophthalmologist for a medical eye exam on the same day, both vision and medical insurance plans may be billed. Refer to your own insurance policy(s) to determine specific benefit details.
|New Patient Comprehensive Eye Exam||92004||$165|
|Established Patient Comprehensive Eye Exam||92014||$135|
|New Patient Medical Eye Exam||99203||$120|
|Established Patient Medical Eye Exam||99213||$100|
Medical Eye Exams are generally performed to evaluate and treat conditions such as diabetes and the eyes, cataracts, glaucoma, macular degeneration, dry eyes, infections, injuries, etc.
Exams are billed as a “New Patient” for any first time visit to the office or if it has been 3 years or more since the last visit to the office.
The above listed fees do not include charges for additional diagnostic tests that may be indicated for conditions such as glaucoma, cataracts, diabetes, macular degeneration, etc., nor does it include any procedure that may be performed on the same day.
An initial and/or yearly Contact Lens Evaluation is a separate fee in addition to a routine eye exam and/or medical exam, and is typically not covered by your vision or medical plan.
Our office will submit services rendered to your insurance company as applicable. It is the insurance company that makes the final determination on any out of pocket expenses that could be due from you, such as copay, deductible and/or coinsurance. If we participate with your insurance company, we are obligated per our contract with that company to make certain adjustments which will alter (typically decrease) the fees slightly (“contractual write off”). To determine the exact fee for your particular plan you can contact your insurance company. Consultations for eyelid or cosmetic surgery will entail an eye examination and will be billed as a New Patient Medical Eye Exam 99203. That fee and any associated diagnostic tests are separate from and not included in any subsequent fee for the surgery (if performed).