Ophthalmology

Vision Test for Eyeglasses (Refraction)

Please let your doctor or technician know at the beginning of your examination if you are in need of a vision test for eyeglasses (refraction). What is this? This determines your need for lenses to correct your refractive error, also referred to as your refraction, or your eyeglass prescription. This is the part of the exam where the doctor, or other staff member flips various lenses inside the phoropter and asks questions like “Better 1 or Better 2”. We keep asking these questions until we have helped you achieve the best possible vision. This will typically be performed if there is a change in vision, a comprehensive exam, a cataract evaluation, or if we are asked if the glasses need changed.

Why do I have to pay for it? CMS, the department of the federal government that controls Medicare and Medicaid, has decided that refractions are not a payable part of an eye exam. CMS, directly under control of the US Congress, has determined this is a “noncovered” service. That means that you have to pay for that portion of the eye exam. Further, CMS has declared that if we don’t charge you extra for this service, we could receive various forms of punishment. This has been enforced since about 2007. Our fee is $60 for a refraction.

Why don’t we tell you about it during an exam? Many of our colleagues have stopped the exam to say “this part is not covered by insurance – you have to pay for this.” The feedback they received from patients was not pleasant. Most of our patients would be disappointed if we completed the exam without receiving a prescription, so if a refraction appears warranted, we just proceed, unless you tell us to stop.

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