Vision Therapy 9.01.04
Excellus BlueCross BlueShield vision therapy medical policy 9.01.04 has a current effective date of November 20, 2025. The November 2025 annual review kept the policy intent unchanged. Vision therapy that includes orthoptics and occlusion therapy is considered medically appropriate for amblyopia, vision therapy that includes prism adaptation is considered medically appropriate for acquired esotropia before surgical intervention, and vision therapy is considered medically appropriate for convergence insufficiency. Web-based or digital vision therapy, such as Luminopia, RevitalVision and CureSight-CS100, is considered investigational, and vision therapy is considered investigational for all other listed indications, including accommodative and vergence dysfunctions, low vision, myopia, nystagmus, presbyopia, strabismus other than acquired esotropia, age-related macular degeneration, learning disabilities including ADHD, and dyslexia.