Medicare Reimbursement for Visual Field Testing

Topic: Visual Fields

Sponsor: OCULUS

Updated: 08/18/2020

OCULUS

This FAQ addresses the following:

  1. Does Medicare cover visual field testing?
  2. Is visual field testing covered for glaucoma suspect or age-related macular degeneration (AMD)?
  3. Does NCD 80.9 supersede information in the local policy if my MAC publishes a more detailed policy?
  4. What documentation is required in the medical record to support claims for visual field?
  5. Is the physician’s presence required during visual field testing?
  6. Why are there three different CPT codes for visual fields, and how do you distinguish between them?
  7. How much does Medicare allow for these tests, and are there limits on billing with other services?
  8. How often may this test be repeated on a patient?
  9. If coverage of visual fields is unlikely or uncertain, how should we proceed?