Covered comprehensive eye exams are generally available to patients once every 12 or 24 months on a service, fiscal, or calendar year basis. Provide the level of exam necessary to determine your patient’s eye health and visual status.

Patients may also be covered for:

• Essential Medical Eye Care services. For more information, see Essential Medical Eye Care in the VSP Manual.
• Retinal Screening. For more information about the Retinal Screening Value-Added Feature and Retinal Screening Covered Benefit, see Retinal Screening in the VSP Manual.

Eye exams are reimbursed at 80% of your U&C fee, up to the maximum amount shown on the appropriate Advantage Network Fee Schedule, less any exam copay. See Eye Exams in the VSP Manual for additional information. Exam services are paid only once per eligibility period. Don’t balance bill for exams.

View your Advantage Network Fees located under Quick Links and Tools on VSPOnline, then click View Fees link. On the Fee Inquiry page, click Advantage button to view the plan’s fee schedules.