MedicaidCoverageMedium impact
Vision Exam Limit Clarification
Alaska Medicaid·AK · Ophthalmology, Optometry·Program Update
We identified it
Jun 21, 2026
Summary
Alaska Medicaid clarifies that vision exams are limited to one per calendar year, with additional exams for children requiring medical justification and adults requiring prior authorization. The policy specifies which CPT codes are subject to this limit and outlines required components for covered vision exams.
Action Required
Immediately: Billing team must update system to track Alaska Medicaid vision exam frequency - limit to one per calendar year per patient. For children through age 20, submit medical justification with additional exam claims. For adults requiring additional exams, obtain prior authorization from Alaska Medicaid before scheduling. Update encounter forms to alert providers about annual limits and ensure vision exams include all required components listed in policy.