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Vision Exam Limit Clarification
Act
immediately
Effective date
Not stated in the notice
Identified
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.
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What to do
immediately · 4 steps
01Billing team must update system to track Alaska Medicaid vision exam frequency - limit to one per calendar year per patient.
02For children through age 20, submit medical justification with additional exam claims.
03For adults requiring additional exams, obtain prior authorization from Alaska Medicaid before scheduling.
04Update encounter forms to alert providers about annual limits and ensure vision exams include all required components listed in policy.
Codes mentioned
9200292003920049201292014920159201892019920819208292083992029920399204992059921199212992139921499215
Original notice
Vision Exam Limit Clarification
extranet-sp.dhss.alaska.gov · Always check the source before changing claims.
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