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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 : Ophthalmological Examination and Evaluation with General Anesthesia
An ophthalmological examination and evaluation under general anesthesia (procedure codes 92018 and 92019) performed by an ophthalmologist may be medically necessary when a client has significant injury or cannot otherwise tolerate the procedure while conscious.
Procedure codes 92018 and 92019 may be reimbursed once per service, per day, when billed by any provider.

Texas Medicaid & Healthcare Partnership
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