We’re offering a billing reminder for optometrists and ophthalmologists who treat Tufts Health Together members.
As indicated on our Tuft Health Plan Vision Services Payment Policy, and in alignment with industry standard correct coding as well as regulatory guidance from MassHealth, routine eye exams should be reported using CPT codes 92002, 92004, 92012, and 92014.
Routine vision services not reported in this fashion will deny — for example, those billed with medical evaluation and management codes in the 99201-99205 range.
In the event that you receive such a denial, you have the option to resubmit the claim using a more appropriate code for reimbursement, in accordance with the corrected claim information outlined in the Claim Requirements, Coordination of Benefits and Dispute Guidelines section of the Tufts Health Public Plans Provider Manual.