Optometry & Ophthalmology Billing & RCM
Optometry & Ophthalmology billing and revenue cycle, 50-state coverage.
Optometry and ophthalmology billing services from ASP-RCM Solutions. 47,746 NPPES optometry / ophthalmology billing providers across all 50 states + DC. BHCOE channel partner. HIPAA + SOC 2 Type II compliant. Senior partners on every account.
What good optometry / ophthalmology billing execution looks like.
The operating discipline we install on every optometry / ophthalmology billing engagement.
- Comprehensive eye exam vs E/M decisionEye care providers choose between ophthalmology E/M codes (92002-92014) and medical E/M codes (99202-99215) per visit. your state practices need rules for when to use which.
- Refraction billing vs medical billing separationRefraction (92015) is typically not covered by medical insurance. your state practices need clean separation between covered medical eye care and self-pay refraction services.
- Cataract surgery + IOL billingCataract surgery (66984) plus IOL device billing (V2632 for standard, premium IOL upgrade for patient self-pay) requires accurate facility/professional split and patient responsibility tracking.
- Diagnostic imaging (OCT, fundus photo) billingOCT (92133, 92134), fundus photography (92250), and visual field testing (92083) carry distinct codes with frequency limits and medical necessity criteria.
- Glaucoma + retina specialty codingGlaucoma SLT (65855), iStent (0191T), and retina anti-VEGF injections (67028 + J-codes) require specialty coding depth.
- Medicare vision benefit limitationsMedicare typically covers medical eye care but not routine vision (refraction, eyeglasses). your state practices need to set patient expectations and bill correctly.
Top optometry / ophthalmology billing markets by NPPES org count.
State-level RCM guides for the largest optometry / ophthalmology billing markets in the U.S.