Billing for vision care services

Priority Health member discount

Priority Health members, regardless of plan, are entitled to receive a 15% discount on ophthalmic materials from optometrists contracted with Priority Health. The member must pay in full at the time of the order.

• Discount does not apply to professional services or exams.
• Opthalmic materials include prescription lenses and lens add-ons, frames, contact lenses and fitting of contact lenses.
• Disposable contact lenses are excluded.
• Discount cannot be used in conjunction with any non-Priority Health vision plan.
• There is no limit on the number of times the discount may be used.

Priority Health Medicare patients

Vision services (i.e. eyeglasses) after cataract surgery are billable. In addition, PriorityMedicare and PriorityMedicare Plus^SM plans cover eyeglasses every two years; PriorityMedicare Value^SM does not.

---

Other topics in this section:

• Cataract surgery limitations
• Contact lenses limitations
• Diabetic retinal exams
  
• Diagnosis codes
• Medicaid patients, allowed services
• Optometrist scope of service, including codes and allowed payments
• Refraction services