Optometric Billing-Submitting Refractions to Medicare-92015

For those of you who are not sure, you can not bill Medicare for a refraction...it is considered to be part of an eye exam by default and is therefore "statutorily excluded" from being billed (ref: EyeCor, 2014). However, you do have options.

1) You can bill your patients at the time of service for this service, ALWAYS MAKE SURE TO GIVE YOUR PATIENTS AN ABN (CALL opticXpress at 866-688-3335 x1 if you need a copy of one) informing them in advance of your intention to do this.
2) Don't bill Medicare for the refraction at all
3) Include the refraction on your claim but use a "GY" modifier. This will signify to Medicare that you know this service is not covered and you have informed of this via an "ABN". (Hint; if you chose option 1, you will need to perform option 3 as well).

 As always, opticXpress is here to help! Click here to contact us today and let us handle your optometric billing for you!