MedicaidBilling CodesHigh impact
Changes in Billing Policy for Vision Examination Code and Additional Dispensing Fee Code for Bifocals
Illinois Medicaid - HFS·IL · Optometry, Ophthalmology·Provider Notice
Effective date
Apr 15, 2008
We identified it
Jun 21, 2026
Summary
Vision examination billing changes: Stop using modifier 22 with CPT 92015 for full optometric exams immediately. Instead, bill CPT 92015 with appropriate E&M codes or use ophthalmology codes 92002-92014. New CPT 92341 added for bifocal dispensing fees.
Action Required
Immediately: Stop billing modifier 22 with CPT 92015. Update billing system to require CPT 92015 with appropriate E&M codes OR use codes 92002-92014 for full optometric exams. Add CPT 92341 for bifocal dispensing fees on HFS 1443 forms. Train staff on new code combinations and update encounter forms.