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VISUAL
Irlen Method Screening and Irlen Colored Lenses (January 18, 2001) Visual Fee Schedule (September 11, 2000) Visual Fee Schedule (July 28, 2000) Visual Schedule (Oct. 1, 1998)
AMENDED – MAY 16, 2002 MS-CE-99-00-35 ORIGINAL DATE: July 20, 2000 RE: Visual Fee Schedule
AMENDED (MAY 16, 2002): AMENDED PROCEDURE 00009: EFFECTIVE IMMEDIATELY, A $25.00 DISPENSING FEE MAY ALSO BE ALLOWED WHEN EYEGLASSES PURCHASED FROM VENDOR WRITING THE PRESCRIPTION. Low Vision Aids (See Code 00020) has been added for which Vendor’s Cost Plus 20% Mark-Up can be allowed.
UPDATE – All By Reports (BR’s) have been removed from the Unit Price Column of the Visual Fee Schedule since the Vendor’s Cost is to be allowed for the involved procedures. It is not necessary to first obtain approval from either John Thomas or Marian Spencer to allow the vendor’s actual cost for Procedures 00008, 00009, 00010, 00011, 00012, or 00017. An updated Visual Fee Schedule to be used by both the Department for the Blind and the Department of Vocational Rehabilitation will become effective on August 1, 2000. Separate fee schedules will no longer exist.
Visual Fee Schedule Procedure 00001 is to be used for an optometrist’s examination. Do not use Relative Value Schedule Procedures 92002, 92004, 92012, or 92014 when authorizing for an optometrist’s examination.
A major change on the fee schedule will be allowing the vendor’s actual cost for eyeglass lens/lenses with a separate flat fee being paid for the frames. Regardless of whether single vision, bifocal, or trifocal lenses are being prescribed, the vendor’s cost is to be allowed. For eyeglass frames, the following amounts are to be allowed: $34.00 for plastic frames, $48.00 for (metal, plastic) middle combination frames, or $60.00 for metal frames.
Another major revision will be the manner in which contact lenses are to be purchased. The vendor’s actual cost for contact lens/lenses plus a fitting fee of $50.00 for one or two contacts is to be allowed.
Prior to issuing a pay document for visual services to be provided on or after August 1, 2000, please inform any vendor of the revisions that have been made in the methods and/or rates of payment for optometric examinations, eyeglasses, and contact lenses. Feel free to provide copies of the revised fee schedule to your vendors.
Work on updating the Visual Fee Schedule was done by the DFB/DVR Fees Team. Team members sought input from various staff and vendors. Should you have any questions regarding the schedule, please feel free to contact John Thomas, DFB, or Marian Spencer, DVR.
VISUAL FEE SCHEDULE Item Number Unit Price Description
00001 45.00 COMPLETE OPTOMETRIC EXAMINATION AND REPORT, OPTOMETRIST 00002 60.00 LOW VISION EVALUATION, 30 MINUTES OR LESS 00003 150.00 LOW VISION EVALUATION, OVER 30 MINUTES, TO INCLUDE FOLLOW-UP 00004
50.00
LOW VISION EVALUATION, ON-SITE OR EXTENSIVE FOLLOW-UP 00005 34.00 FRAMES, PLASTIC FOR GLASSES (INCLUDING CATARACT GLASSES) 00006 48.00 FRAMES, RONSIR-ZYL (METAL PLASTIC) MIDDLE COMBINATION 00007 60.00 FRAMES, METAL 00008 99999.00 EYEGLASSES – VENDOR’S COST OF LENSES 00009 25.00 DISPENSING FEE FOR EYEGLASSES 00010
99999.00
REPLACEMENT EYEGLASSES LENSES ONLY – 00011
99999.00
TINT FOR EYEGLASSES (MUST BE PRESCRIBED) – 00012 99999.00 UV PROTECTION FOR EYEGLASSES (MUST BE PRESCRIBED) –VENDOR’S COST 00013 99999.00 CONTACT LENS/LENSES – VENDOR’S COST 00014 50.00 FITTING FEE FOR ONE OR TWO CONTACTS 00015 660.00 SCLERAL SHELL 00016 300.00 PLASTIC ARTIFICIAL EYE (STOCK) 00017 650.00 CUSTOM PLASTIC ARTIFICIAL EYE 00018 99999.00 INTRAOCULAR LENS IMPLANT MATERIAL – VENDOR’S COST 00019 200.00 EYE CONFORMER 00020 99999.00 LOW VISION AIDS – VENDOR’S COST + 20% MARK UP
ORIGINAL DATE: JULY 20, 2000
SERVICE FEE MEMORANDUM DATE: January 18, 2001 RE: Irlen Method Screening and Irlen Colored Lenses Vision Therapy/Gottlieb Visual Field Awareness System The Kentucky Department of Vocational Rehabilitation and the Department for the Blind will not provide coverage for the Irlen Method Screening and Irlen Colored Lenses for Scotopic Sensitivity/Irlen Syndrome. Also, coverage will not be provided for Vision Therapy that employs the Gottlieb Visual Field Awareness System.
A joint statement of the American Academy of Pediatrics, American Association for Pediatric Ophthalmology and Strabismus and the American Academy of Ophthalmology notes that "No scientific evidence supports claims that the academic abilities of children with learning disabilities can be improved with treatments that are based on 1) Visual training… 2) Neurological organizational training…or 3) Colored lenses."
Based on this statement and the lack of endorsement by the Kentucky Department of Education, DVR and DFB will not provide coverage for either the Irlen Method Screening and Colored Lenses or Vision Therapy.
UPDATE – July 28, 2000 SERVICE FEE MEMORANDUM MS-JT-99-00-35
RE: Visual Fee Schedule
AMENDED: Effective immediately, a $25.00 Dispensing Fee (See Code 00009) may be allowed for Eyeglasses when purchased from Vendor not writing the Prescription. Low Vision Aids (See Code 00020) has been added for which Vendor’s Cost Plus 20% Mark-Up can be allowed.
UPDATE – All By Reports (BR’s) have been removed from the Unit Price Column of the Visual Fee Schedule since the Vendor’s Cost is to be allowed for the involved procedures. It is not necessary to first obtain approval from either John Thomas or Marian Spencer to allow the vendor’s actual cost for Procedures 00008, 00009, 00010, 00011, 00012, or 00017. An updated Visual Fee Schedule to be used by both the Department for the Blind and the Department of Vocational Rehabilitation will become effective on August 1, 2000. Separate fee schedules will no longer exist.
Visual Fee Schedule Procedure 00001 is to be used for an optometrist’s examination. Do not use Relative Value Schedule Procedures 92002, 92004, 92012, or 92014 when authorizing for an optometrist’s examination.
A major change on the fee schedule will be allowing the vendor’s actual cost for eyeglass lens/lenses with a separate flat fee being paid for the frames. Regardless of whether single vision, bifocal, or trifocal lenses are being prescribed, the vendor’s cost is to be allowed. For eyeglass frames, the following amounts are to be allowed: $34.00 for plastic frames, $48.00 for (metal, plastic) middle combination frames, or $60.00 for metal frames.
Another major revision will be the manner in which contact lenses are to be purchased. The vendor’s actual cost for contact lens/lenses plus a fitting fee of $50.00 for one or two contacts is to be allowed.
Prior to issuing a pay document for visual services to be provided on or after August 1, 2000, please inform any vendor of the revisions that have been made in the methods and/or rates of payment for optometric examinations, eyeglasses, and contact lenses. Feel free to provide copies of the revised fee schedule to your vendors.
Work on updating the Visual Fee Schedule was done by the DFB/DVR Fees Team. Team members sought input from various staff and vendors. Should you have any questions regarding the schedule, please feel free to contact John Thomas, DFB, or Marian Spencer, DVR.
SERVICE FEE MEMORANDUM MS-JT-99-00-35
ORIGINAL DATE: July 20, 2000 UPDATE: July 28, 2000
RE: Visual Fee Schedule
UPDATE – All By Reports (BR’s) have been removed from the Unit Price Column of the Visual Fee Schedule since the Vendor’s Cost is to be allowed for the involved procedures. It is not necessary to first obtain approval from either John Thomas or Marian Spencer to allow the vendor’s actual cost for Procedures 00008, 00009, 00010, 00011, 00012, or 00017. An updated Visual Fee Schedule to be used by both the Department for the Blind and the Department of Vocational Rehabilitation will become effective on August 1, 2000. Separate fee schedules will no longer exist.
Visual Fee Schedule Procedure 00001 is to be used for an optometrist’s examination. Do not use Relative Value Schedule Procedures 92002, 92004, 92012, or 92014 when authorizing for an optometrist’s examination.
A major change on the fee schedule will be allowing the vendor’s actual cost for eyeglass lens/lenses with a separate flat fee being paid for the frames. Regardless of whether single vision, bifocal, or trifocal lenses are being prescribed, the vendor’s cost is to be allowed. For eyeglass frames, the following amounts are to be allowed: $34.00 for plastic frames, $48.00 for (metal, plastic) middle combination frames, or $60.00 for metal frames.
Another major revision will be the manner in which contact lenses are to be purchased. The vendor’s actual cost for contact lens/lenses plus a fitting fee of $50.00 for one or two contacts is to be allowed.
Prior to issuing a pay document for visual services to be provided on or after August 1, 2000, please inform any vendor of the revisions that have been made in the methods and/or rates of payment for optometric examinations, eyeglasses, and contact lenses. Feel free to provide copies of the revised fee schedule to your vendors.
Work on updating the Visual Fee Schedule was done by the DFB/DVR Fees Team. Team members sought input from various staff and vendors. Should you have any questions regarding the schedule, please feel free to contact John Thomas, DFB, or Marian Spencer, DVR.
MS-98-99-1
DATE October 1, 1998 RE: Visual Schedule
DEPARTMENT OF VOCATIONAL REHABILITATION VISUAL SCHEDULE EFFECTIVE OCTOBER 1, 1998 CODE PROCEDURE DVR ALLOWABLE FEE
00001 Complete optometric examination, to include Use CPT Codes refraction and report 92002, 92004,92012, or 92014 00002 Low vision aid examination, 30 minutes or less, to include report and follow-up $ 60.00 00003 Low vision aid examination, over 30 minutes, to include glare test, refraction, report, and follow-up 120.00 00004 Low vision aid examination, over 1 hour, on site or extensive follow-up over 1 hour 50.00 00005 Glasses, single vision lenses with frames, heat-tempered or plastic for impact 95.00 00006 Glasses, kryptok bifocals with frames, heat-tempered or plastic for impact 115.00 00007 Glasses, flat-top bifocals with frames, heat-tempered or plastic for impact 120.00 00008 Glasses, flat-top trifocals with frames, heat-tempered or plastic for impact 130.00 00009 Glasses, plastic microscopic lenses in frames - 2 or 4 power monofocal 115.00 00010 Glasses, plastic microscopic lenses in frames - 2 or 4 power bifocal 145.00 00011 Glasses, plastic microscopic lenses in frames - 6, 8, 10, and 12 power monofocal 145.00 00012 Glasses, plastic microscopic lenses in frames - 6, 8, 10, and 12 power bifocal 175.00 00013 Glasses, one plastic aspheric cataract lens with balance lens and frames 165.00 00014 Glasses, one pair plastic aspheric cataract lenses with frames 180.00 00015 Glasses, one pair plastic aspheric cataract lenses with flat-top frames 200.00 00016 Glasses, one pair Welsh Four Drop Aspheric M.E.D. lenses with frames 200.00 00017 Glasses, prism, per lens 15.00 00018 Glasses, tinting of glass lenses (must be prescribed by ophthalmologist or optometrist) 15.00 00019 Glasses, tinting of plastic lenses (must be prescribed by ophthalmologist or optometrist) 16.00 00020 Glasses, replace single vision lenses only 50.00 00021 Glasses, replace bifocal lenses only 75.00 00022 Glasses, replace frames only (standard plastic frames) 50.00 00023 Contact lenses, spherical hard, one lens 82.00 00024 Contact lenses, spherical hard, two lenses 145.00 00025 Contact lenses, 30%, bi-toric, one lens 112.00 00026 Contact lenses, 30%, bi-toric, two lenses 175.00 00027 Contact lenses, spherical gas permeable, one lens 95.00 00028 Contact lenses, spherical gas permeable, two lenses 170.00 00029 Contact lenses, toric gas permeable, one lens 120.00 00030 Contact lenses, toric gas permeable, two lenses 220.00 00031 Contact lenses, spherical soft, one lens (includes aceptor-sterilizer) 90.00 00032 Contact lenses, spherical soft, two lenses (includes aceptor-sterilizer) 160.00 00033 Contact lenses, toric soft, one lens 110.00 00034 Contact lenses, toric soft, two lenses 200.00 00035 Prosthetic eye, plastic, stock 300.00 00036 Prosthetic eye, plastic, custom 660.00
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