Service Description

Service Description: Vision services include evaluation and assessment of visual functioning; diagnosis and appraisal of specific visual disorders, delays and abilities; dispensing of eyeglasses and referral for medical or other professional services necessary for the habilitation or rehabilitation of visual functioning disorders.

Vision services, also include:

  1. services related to visual functioning,
  2. orientation and mobility training for all environments,
  3. communication skills training,
  4. visual training,
  5. independent living skills training and
  6. additional training necessary to activate visual motor abilities.

Family training, education and support provided to assist the family of a child eligible for services in understanding the special needs of the child related to vision services and enhancing the child's development are integral to this service. Eligible child is not required to be present but may be if appropriate. May include such services as support groups, individual support and other training or education for the family.

Services must be consistent with the provider's qualifications and licensure.

NOTE: Early Intervention does not pay for therapeutic services required due to, or as part of, a medical procedure, a medical intervention or an injury. Acute rehabilitative therapy and therapy required as part of a medical procedure, medical intervention or injury, is not developmentally-based but is medically-based. Once the condition has become chronic or sub-acute the therapy for the on-going developmental delay can be provided by EI.

Qualified Staff: 1) System enrolled Licensed Registered Optometrist or licensed Ophthalmologist, and 2) System enrolled specialist credentialed as a Developmental Therapist/Vision. (See ATTACHMENT 5: REQUIREMENTS FOR PROFESSIONAL AND ASSOCIATE LEVEL EARLY INTERVENTION CREDENTIALING AND ENROLLMENT TO BILL.).

Billable Activities Optometric examination, dispensing fee, assessment, IFSP development

With Authorization: (see DEFINITIONS of IFSP development) and direct services.

Do not provide services without having an authorization in hand. Services provided without a pre-approved authorization are not guaranteed for payment.

Procedure codes listed below are for use to determine the need for eyeglasses, to dispense eyeglasses and to make a referral to a medical doctor for medical testing, if the need is identified.

Procedure Codes Modifiers Unit of Service Description Rate
92015 n/a Optometric examination $29.27
92340 n/a Dispensing fee $12.33

Procedure Codes listed below are for use by Illinois Department of Corrections only.

Procedure Codes Modifiers Unit of Service Description Rate
V2020 V2025 n/a Frame varies
varies n/a Pair of lenses (same Rx) varies
varies n/a Right lens (different Rx) varies
varies n/a Left lens (different Rx) varies

NOTE

Prescriptions for eyeglasses must be submitted to the CBO along with the bill for the Optometric examination and the dispensing fee using "optical prescription order forms" from the Illinois Department of Corrections. The CBO will make arrangements to fill the prescription as ordered (See Attachment 4 for procedure and form information).

Procedure Codes listed below are for Vision Services

Procedure Codes Modifiers Unit of Service Description Rate
99173    15 minutes Assessment - onsite $10.71
99173    15 minutes Assessment - offsite $13.50
T1024 SE 15 minutes IFSP development $10.71
T1024 SE 15 minutes IFSP meeting $13.50
V2799    15 minutes Vision services - onsite $10.71
V2799    15 minutes Vision services - offsite $13.50
V2799 HQ 15 minutes Group vision services (multiple families or group not to exceed 4 children) $2.68