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Exam Coverage
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Exam Coverage

Covered comprehensive eye exams are generally available to patients once every 12 or 24 months on a service year, fiscal year, or calendar year basis. Provide the level of exam necessary to determine your patient’s eye health and visual status.

Patients may also be covered for:

  •  Essential Medical Eye Care services. For more information, see Essential Medical Eye Care in the VSP Manual.
  •  Retinal Screening. For more information about the Retinal Screening Value-Added Feature and Retinal Screening Covered Benefit, see Retinal Screening in the VSP Manual.

Your assigned VSP Choice Plan® eye exam fees are based on levels of service. See Eye Exams in the VSP Manual for additional information. Exam services are paid only once per eligibility period. Don’t balance bill for exams.

Note: 

Avoid reduced reimbursement. Bill separately for refraction (92015). Your Choice Network Fee Schedule lists your refraction fee.