MedicaidReimbursementMedium impact
Notice to Local Educational Agency (LEA) Providers - Procedure Code 99173 – EPSDT Vision Screening Rate Correction
Louisiana Medicaid·LA · Pediatrics, Family Medicine, Optometry·Claims & Billing
Effective date
Jul 8, 2025
We identified it
Jun 18, 2026
Summary
Louisiana Medicaid has corrected the reimbursement rate for procedure code 99173 (EPSDT Vision Screening) for Local Educational Agency providers from $2.00 to $10.00, effective July 8, 2025. Claims paid at the incorrect rate between April 2023 and July 2025 will be automatically recycled with an additional $8.00 payment per claim on September 9, 2025.
Action Required
By July 8, 2025: LEA providers should verify billing system reflects the corrected $10.00 reimbursement rate for CPT 99173. Monitor September 9, 2025 remittance advice for automatic $8.00 adjustment payments on previously underpaid claims from April 2023-July 2025. Contact Gainwell Technologies at (800) 473-2783 with questions about recycled claims.