Fee Navigator®

    Health Service Code 09.01F

    Complete oculo-visual examination

    NOTE:
    1. Non-insured for residents aged 19 through 64 years.
    2. May not be claimed in addition to any other complete examinations (03.04A, 03.04AZ, 03.08A, 03.08AZ, 03.08H and 09.04).
    3. Intended for those circumstances in which a routine periodic eye examination is provided.
    4. Claims may be submitted once every benefit year (July 1 - June 30) for residents 18 years of age or younger and 65 years and older.
    Category:V Visit
    Base rate:$36.85

    Fee modifiers:

    No modifiers.

    Governing Rules: