MedicaidCoverageMedium impact
Vision Change CPT Codes
Kentucky Medicaid·KY · Optometry·Coding
Effective date
Jan 1, 2023
We identified it
Jun 20, 2026
Summary
Kentucky Medicaid is removing the two visits per year per provider limitation on CPT codes 99211, 99212, and 99213 for vision providers. This change is retroactive to January 1, 2023, allowing unlimited visits for these evaluation and management codes.
Action Required
Immediately: Billing team should review and resubmit any Kentucky Medicaid claims for CPT codes 99211, 99212, and 99213 that were denied due to the two-visit limitation since January 1, 2023. Update billing system rules to remove visit frequency limits for these codes on the Kentucky Medicaid Vision Fee Schedule.