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CSHCN Services Program Reimbursement Rates Change for Optometrists’ Office Visits
Information posted December 5, 2008: Effective for dates of service on or after September 1, 2007, the Children with Special Health Care Needs (CSHCN) Services Program reimbursement rates have changed for optometrists’ office visits. Claims submitted with dates of service on or after September 1, 2007, will be reprocessed, and payments will be adjusted accordingly. No action on the part of the provider is necessary. Click on the title to view the details.

The following reimbursement rates for optometrists’ office visits are effective for dates of service on or after September 1, 2007.

Procedure Code

Medicaid Reimbursement Rate

E-92002

$53.56 (1.87 relative value units [RVUs], $28.640 conversion factor)

E-92004

$94.51 (3.30 RVUs, $28.640 conversion factor)

E-92012

$46.40 (1.62 RVUs, $28.640 conversion factor)

E-92014

$69.88 (2.44 RVUs, $28.640 conversion factor)

For more information, call the TMHP-CSHCN Services Program Contact Center at 1-800-568-2413.

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