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December 2016 Texas Medicaid Provider Procedures Manual

Vision and HearingServices Handbook : 4 Vision Care Professionals : 4.3 Services, Benefits, Limitations, and Prior Authorization : 4.3.5 Vision Testing

4.3.5
Vision testing and examination and treatment of eye conditions are benefits of Texas Medicaid and may be reimbursed to ophthalmologist or optometrist providers.
Eye examinations with refraction testing may be reimbursed using the following procedure codes:
 
Medical evaluation and examination may be reimbursed using the following procedure codes:
 
Procedure codes 92002, 92004, 92012, and 92014 are limited to one service per day by any provider.
Refer to:
Subsection 9.2.56.1.1, “New and Established Patient Services” in Medical and Nursing Specialists, Physicians, and Physician Assistants Handbook (Vol. 2, Provider Handbooks) for information about new patient and established patient E/M services.
Vision testing procedure codes are subject to the CMS NCCI relationships. Claims that are submitted by physicians with the same specialty who are in the same group practice are processed as if they were the same provider. Providers should refer to the Current Procedural Terminology (CPT) Manual for additional information about intermediate and comprehensive ophthalmological services.

Texas Medicaid & Healthcare Partnership
CPT only copyright 2014 American Medical Association. All rights reserved.