How much does an eye exam cost?

[FutureIrishOD]

After reading in this forum, I realized I didn't know what the average cost of an eye exam is, so I think it would be a good idea if people listed how much they charge or were charged for an eye exam and the type of setting they are in. I am a tech for a Lenscrafter doctor in Texas and our prices are:

Basic eye exam: $54
New Fatient Contact Lens fit: $95 to $145 plus the cost of the basic eye exam. (the cost very on the type of fit RGP, Toric, or Mono Vision/bifocal)
Returning Patient Contact Lens Fit: $44 plus the basic eye exam and $25 for each additional follow up.
Dilation: $20
Optos retinal imaging: $29
Office Visit: $55 and $25 for each additional follow up visit.

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[VA Hopeful Dr]

After reading in this forum, I realized I didn't know what the average cost of an eye exam is, so I think it would be a good idea if people listed how much they charge or were charged for an eye exam and the type of setting they are in. I am a tech for a Lenscrafter doctor in Texas and our prices are:

Basic eye exam: $54
New Fatient Contact Lens fit: $95 to $145 plus the cost of the basic eye exam. (the cost very on the type of fit RGP, Toric, or Mono Vision/bifocal)
Returning Patient Contact Lens Fit: $44 plus the basic eye exam and $25 for each additional follow up.
Dilation: $20
Optos retinal imaging: $29
Office Visit: $55 and $25 for each additional follow up visit.

I think its best to use medicare fees, they tend to be about market value:

New patient comprehensive exam: 121.42
Established patient comprehensive: 89.85
Visual Fields (automated usually): 67.64
Office Visit level 1: 19.79
Level 5: 112.95
Retina photos: 41.38

 

[drgregory]

92004 = 162
92015 = 97
92310 new sphere = 97
92310 new toric =109
92310 new multi = 139
92310 est sphere = 59
92310 est toric = 67
92310 est multi = 89

99204 = 174
99214 = 127
99202 = 59
99212 = 59

 

[in_translation]

For those who are unaware of the above codes, I looked up some of them:
92004 - new patient eye exam
92015 - refraction
92310 - contact lens fitting
99204, 99202 - office/outpatient visit (new)
99214, 99212 - office/outpatient visit (est)

 

[beachbum82]

the place i work for is a private practice in southern california....our fees are as follows:

comprehensive exam (new and established; as well as existing contact lens patients) = 83.00, this fee includes any follow up visits
office visit = 45.00, also includes follow up visits
dfe = included in exam cost
new contact lens patient fit = 62-117 not including materials

 

[ny_grl]

the place i work for is a private practice in southern california....our fees are as follows:

comprehensive exam (new and established; as well as existing contact lens patients) = 83.00, this fee includes any follow up visits
office visit = 45.00, also includes follow up visits
dfe = included in exam cost
new contact lens patient fit = 62-117 not including materials

In New York City

Contact Lens exam: $125(sperical Rx) - $ 175(astigmatic Rx, gas permeable lenses , etc)
Eye Exam : $75
Emergency visit : $55
VF/DFE/Fundus Photos: $20 each.

 

[VA Hopeful Dr]

92004 = 162
92015 = 97
92310 new sphere = 97
92310 new toric =109
92310 new multi = 139
92310 est sphere = 59
92310 est toric = 67
92310 est multi = 89

99204 = 174
99214 = 127
99202 = 59
99212 = 59

I don't mean to be judgemental, but you charge 100 bucks refraction fee?

 

[xmattODx]

I don't mean to be judgemental, but you charge 100 bucks refraction fee?

It is a drgregory refraction! Worth every penny.

 

[drgregory]

92015 = 97. you bet. i should charge 3 times that amount - the technician does it, then the intern does it, then i do it.

 

[blazenmadison]

In New York City

Contact Lens exam: $125(sperical Rx) - $ 175(astigmatic Rx, gas permeable lenses , etc)
Eye Exam : $75
Emergency visit : $55
VF/DFE/Fundus Photos: $20 each.

We charge $75 for an eye exam too. But we're not NYC. We have a population of 40,000. OUr spherical cls are 135 and toric are 170.

 

[VA Hopeful Dr]

92015 = 97. you bet. i should charge 3 times that amount - the technician does it, then the intern does it, then i do it.

Why do it 3 times, unless you're just double checking/fine tuning the previous 2. But then again, if it was me, I wouldn't care if Jesus himself was doing it, $100 refraction fee is 3X higher than anything I've ever seen before.

 

[Hines302]

Why do it 3 times, unless you're just double checking/fine tuning the previous 2. But then again, if it was me, I wouldn't care if Jesus himself was doing it, $100 refraction fee is 3X higher than anything I've ever seen before.

and now we have come full circle. there in lies the major problem. OD's charging to little for professional services.

 

[rpames]

This is a summary of what was told to us during a practice management class.

"Do MD's flitch when they tell you how much a procedure will cost, does a dentist blink when they tell you the fee for a filling, doesn't the mechanic smile when he tells you it will be $900 for a new air-conditioner, and doesn't the plumber laugh when he tells you what it will be to fix the water heater?"

Why do we (ODs) feel so bad to charge our patients? Why do some people get mad to pay us to make them SEE! Yet they will go to the mall and drop $80 on jeans, $60 on a top, $90 on some shoes, and $400 on a purse and not think twice? Most patients won't care what you charge and if they do, they can go done the street to "Refract-a-Hut." Trust me, you don't want most of those patients anyway. We go through a lot of schooling and go into a lot of debt to proved a service they need! I went to the dentist the other day and at the end I handed over my card and didn't think twice. I refuse to feel bad charging people who have a $300 cell phone in there hand and were just texting a friend and then check the sports scores. A plan like that is over $100 per month. Or the ones who have a $500 purse on there shoulder.

Everyone pays for what they feel is important. Personally I think ones vision has priority over some designer jeans. Therefore, I will charge what I'm worth, not what I think someone is willing to pay.

 

[xmattODx]

and now we have come full circle. there in lies the major problem. OD's charging to little for professional services.

I think the concern is with a nearly $100 REFRACTION not an eye exam simply a refraction.

 

[VA Hopeful Dr]

I think the concern is with a nearly $100 REFRACTION not an eye exam simply a refraction.

Exactly. Remember, 95% of refraction can easily be done in 10 minutes by someone with just a high school degree. That's not worth $100. Now, I could see scaling your refraction fee based on complexity of Rx... that'd be different.

And in response to Hines302: This is only about refraction. I fully think that for exams, and other things that only an OD or MD can do, you should charge appropriately.

 

[Hines302]

I think the concern is with a nearly $100 REFRACTION not an eye exam simply a refraction.

AHHHHH. I understand now. That is a bit expensive

Just out of curiosity... how much does a dentist charge for a teeth cleaning. It is really a dental hygenist that does this, and it really doesnt take that long either.

 

[drgregory]

AHHHHH. I understand now. That is a bit expensive

Just out of curiosity... how much does a dentist charge for a teeth cleaning. It is really a dental hygenist that does this, and it really doesnt take that long either.

at least someone gets it.

 

[VA Hopeful Dr]

AHHHHH. I understand now. That is a bit expensive

Just out of curiosity... how much does a dentist charge for a teeth cleaning. It is really a dental hygenist that does this, and it really doesnt take that long either.

I was under the impression that a cleaning was part of the twice yearly dental exam.

Dental Hygenists - Clean/floss/flouride/maybe x-ray (x-rays might be billed separately)
OD assistants - Acuity/autorefractor/tonometry/refraction/maybe fundus photos (photos billed separately)

Dentist - Reviews x-rays, examines gums/teeth/jaws
OD - Reviews photos, examines anterior seg/posterior seg/vitreous/retina

Seems fairly even to me, no reason to tack on $100 to the exam fee.

 

[drgregory]

I was under the impression that a cleaning was part of the twice yearly dental exam.

Dental Hygenists - Clean/floss/flouride/maybe x-ray (x-rays might be billed separately)
OD assistants - Acuity/autorefractor/tonometry/refraction/maybe fundus photos (photos billed separately)

Dentist - Reviews x-rays, examines gums/teeth/jaws
OD - Reviews photos, examines anterior seg/posterior seg/vitreous/retina

Seems fairly even to me, no reason to tack on $100 to the exam fee.

two months ago i underwent a "dental examination", as well as a cleaning, as well as X-ray (only one). my bill is as follows:

dental examination = $167
cleaning = $78
X-ray = $47

and then i later need a filling and a crown, so tack on another $1238 to the above. wake up ODs - we're way behind.

 

[Hines302]

wow.... $1,238 for a filling and a crown.

the thing is I cant think of any services (procedures) that an OD can charge that much for??

... If a dentist can charge 78 dollars for a cleaning... I see no problem with an OD charging the same amount for a refraction. I would consider both taking about the same amount of time (maybe a little more for the cleaning) and same skill level involved. Agree or disagree???

 

[rpames]

wow.... $1,238 for a filling and a crown.

the thing is I cant think of any services (procedures) that an OD can charge that much for??

... If a dentist can charge 78 dollars for a cleaning... I see no problem with an OD charging the same amount for a refraction. I would consider both taking about the same amount of time (maybe a little more for the cleaning) and same skill level involved. Agree or disagree???

Ortho-K, punctal plugs, corneal rehab.

 

[VA Hopeful Dr]

two months ago i underwent a "dental examination", as well as a cleaning, as well as X-ray (only one). my bill is as follows:

dental examination = $167
cleaning = $78
X-ray = $47

and then i later need a filling and a crown, so tack on another $1238 to the above. wake up ODs - we're way behind.

I stand corrected. Although the x-ray bill is about the same as a good fundus photo, for what that's worth. Was this the bill through insurance, or was this U/C?

Optometry should consider doing what dentistry did several years ago: reduce the number of new ODs coming out every year. Also, get the AOA to concentrate more on economics than surgery, and get the ophthalmologists in on this too. Dentistry closed a few schools and has a VERY organized national organization. Does wonders.

 

[drgregory]

Optometry should consider doing what dentistry did several years ago: reduce the number of new ODs coming out every year. Also, get the AOA to concentrate more on economics than surgery, and get the ophthalmologists in on this too. Dentistry closed a few schools and has a VERY organized national organization. Does wonders.

now we're talking. you nailed it. where do i sign?

 

[VA Hopeful Dr]

now we're talking. you nailed it. where do i sign?

It really is an amazing difference. I was at the Orlando ARBO meeting in 2004 (damn that was a nice place). The ADA was just leaving as we all got there and I had a chance to read over some little stuff they'd left behind. Much more organized and focused than the AOA. Can't help but wonder how they pulled that one off.

 

[xmattODx]

The ADA was just leaving as we all got there and I had a chance to read over some little stuff they'd left behind. Much more organized and focused than the AOA. Can't help but wonder how they pulled that one off.

Haven't you been following all of the threads? Dentists are smarter! They don't let in just anyone you know. Optometry on the other hand...


Just to be clear I'm really just kidding. Don't attack me... please.

 

[rpames]

We just needed to wait until be get a visionary at the helm of the AOA. Dr. Borsh and the other founders changed optometry several decades ago. They have since stepped to the side. Now we just need another person to lead us in the right direction. Dentistry had great leaders with a focused plan, we have great leaders, but we are to segregated. Each state has different requirements and different scopes. How can we all make a unified front when one state can do laser surgery and others are still fighting to Rx oral drugs. Once we all are the same playing field we will be able to mold the profession in the direction we need it to be.

 

[VA Hopeful Dr]

Haven't you been following all of the threads? Dentists are smarter! They don't let in just anyone you know. Optometry on the other hand...


Just to be clear I'm really just kidding. Don't attack me... please.

Its all scare tactics. Who would you rather ignore: a guy with a tooth drill, or a guy with an ophthalmoscope?

 

[Hines302]

Its all scare tactics. Who would you rather ignore: a guy with a tooth drill, or a guy with an ophthalmoscope?

maybe if we threatened to blow air into everyone's eyes

 

[Calliefornia]

After reading in this forum, I realized I didn't know what the average cost of an eye exam is, so I think it would be a good idea if people listed how much they charge or were charged for an eye exam and the type of setting they are in. I am a tech for a Lenscrafter doctor in Texas and our prices are:

Basic eye exam: $54
New Fatient Contact Lens fit: $95 to $145 plus the cost of the basic eye exam. (the cost very on the type of fit RGP, Toric, or Mono Vision/bifocal)
Returning Patient Contact Lens Fit: $44 plus the basic eye exam and $25 for each additional follow up.
Dilation: $20
Optos retinal imaging: $29
Office Visit: $55 and $25 for each additional follow up visit.

Complete Eye Exam with Dilation: $49
Contact Exams: $69 (spherical)
$79 (Toric)
$89 (multifocal or RGP's)
Contact Fit: $20
Refraction: $35


For some reason these seem low.....

 

[cpw]

Complete Eye Exam with Dilation: $49
Contact Exams: $69 (spherical)
$79 (Toric)
$89 (multifocal or RGP's)
Contact Fit: $20
Refraction: $35


For some reason these seem low.....

those ARE low

Mine:

Complete Exam with dilation (cuz it's included, since it should be) $69
Contact Exam (spherical) $99
Contact Exam (toric) $119
Contact Exam (RGP/Mono/Multi) $139


My office is about 80% contact lens exams.

 

[sharky098]

I'm wondering how much these numbers have changed over time. I know this is an older post, but I'm trying to find the same information. I was able to find the Lenscrafter prices for basic exam, dilation, and photos, but not sure if those are consistent with others.

Basic eye exam: $49
Optiscan: $39
Peripheral vision test: $10
Dilation: $15

 

[OD4eyes]

ee 85
cle 150
cle toric 170
IR additional 20
DFE 35
FF 30

 

[stonegoat]

I charge $92 for as full exam...doesn't matter if the patient is new or established. Minor visits are $50. I charge $100 for a CL new fit (includes training), however, my technician does 99% of everything related to CLs. CL refits are $60, however, I mostly "no-charge" them as it's usually as simple as switching someone from an Acuvue 2 to an Oasys....real basic stuff.
My fees are slightly higher than my "competition", however, I would like to more of my revenue come from professional fees and be less dependent on dispensing revenue. I'm heading in that direction.

 

[eyestrain]

Why, in God's name, are people charging extra for DFE? What a bunch of idiots.

 

[JMU07]

Why, in God's name, are people charging extra for DFE? What a bunch of idiots.

I was wondering that too... most people already hate being dilated, and if they're being charged for it...

 

[OD4eyes]

I was wondering that too... most people already hate being dilated, and if they're being charged for it...

Extened ophthalmoscopy is an important procedure in any comprehensive exam. Therefore, doctors should charge the patients for it. From my experience many MDs charge each eye individually for dilation, usually anywhere from 30 to 50 per eye. It is true that patients do not enjoy their eyes being dilated and may feel discomfort. This is why we educate patients and give them the option of having thier eyes dilated. We do not charge them for it if they refuse dilation. Another point that I have to mention is that vision insurances such as eyemed, spectra... DO NOT REIMBURSE for dilation. Therefore, we should charge this procedure separately, especially if these insurances are only paying $44 for a routine exam. Not charging patients for dilation brings the assumption that it is not essential and they will most likely take it for granted.
I could understand if dilation is already apart of $100 exam fee. However, if the rountine exam is ranging 40-85, patients should be charged.

This was just a thought!

 

[KHE]

Extened ophthalmoscopy is an important procedure in any comprehensive exam. Therefore, doctors should charge the patients for it. From my experience many MDs charge each eye individually for dilation, usually anywhere from 30 to 50 per eye. It is true that patients do not enjoy their eyes being dilated and may feel discomfort. This is why we educate patients and give them the option of having thier eyes dilated. We do not charge them for it if they refuse dilation. Another point that I have to mention is that vision insurances such as eyemed, spectra... DO NOT REIMBURSE for dilation. Therefore, we should charge this procedure separately, especially if these insurances are only paying $44 for a routine exam. Not charging patients for dilation brings the assumption that it is not essential and they will most likely take it for granted.
I could understand if dilation is already apart of $100 exam fee. However, if the rountine exam is ranging 40-85, patients should be charged.

This was just a thought!

"Extended Ophthalmoscopy" is NOT the same thing as a dilated retinal exam that is part of a comprehensive eye exam.

 

[OD4eyes]

"Extended Ophthalmoscopy" is NOT the same thing as a dilated retinal exam that is part of a comprehensive eye exam.

However, dilating drops are involved.

 

[KHE]

However, dilating drops are involved.

That doesn't matter. The use of dilating drops is not what separates "extended ophthalmoscopy" which is a billable procedure vs a dilation that occurs as part of a comprehensive eye exam.

 

[OD4eyes]

That doesn't matter. The use of dilating drops is not what separates "extended ophthalmoscopy" which is a billable procedure vs a dilation that occurs as part of a comprehensive eye exam.

I didn't mean to digress. The whole point that I'm trying to make is to not give it away for free. Also, when filing insurance claims, dilation is charged per eye and separatly from the refraction and comprehensive exam. Most medical insurances consider dilation separate procedure and fee. As along as the doctor explains everything clearly, the patient 90% of the time will not have a problem paying extra $35.00 for dilation.

 

[KHE]

I didn't mean to digress. The whole point that I'm trying to make is to not give it away for free. Also, when filing insurance claims, dilation is charged per eye and separatly from the refraction and comprehensive exam. Most medical insurances consider dilation separate procedure and fee. As along as the doctor explains everything clearly, the patient 90% of the time will not have a problem paying extra $35.00 for dilation.

Philosophically, I am opposed to charging extra for dilations that occur as part of comprehensive eye exams. Your dentist doesn't charge extra to look at your back teeth instead of just your front.

Most medical insurances (if not all) do NOT consider the dilation to be separate from the comprehensive eye exams and dilations conducted as part of comprehensive eye exams are NOT billable as a separate procedure.

That is different from "extended ophthalmoscopy" which IS a separate procedure. Are you sure you know the difference between "dilation" and "extended ophthalmoscopy?"

 

[OD4eyes]

Philosophically, I am opposed to charging extra for dilations that occur as part of comprehensive eye exams. Your dentist doesn't charge extra to look at your back teeth instead of just your front.

Most medical insurances (if not all) do NOT consider the dilation to be separate from the comprehensive eye exams and dilations conducted as part of comprehensive eye exams are NOT billable as a separate procedure.

That is different from "extended ophthalmoscopy" which IS a separate procedure. Are you sure you know the difference between "dilation" and "extended ophthalmoscopy?"

Very interesting and clever analogy. However, doesn't everyone charge for fundus photos separately?
The doctors perform both procedures in that $35.00 charge. We explain to the patients that their eyes have to be dilated for the extended ophthalmoscopy. I could see why many people would oppose to this and it is a personal choice on how to charge patients.
I am not sure what insurances you may work with but they will reimburse dilation if medically necessary and appropriate. Routine visions (eyemed, VSP, spectra....) insurances never reimburse. Dilations adds time to the exam process. Time most vision insurances do not consider. We cannot make separate rules for our self-paid patients and routine vision plan patients. Therefore it is only fair if we charge for dilation separately, which many places do in medical, optometry, and even corporate offices. Unlike medical and corporate offices, our optometrists explain efficiently the results and purpose of each exam. They do great job in communicating with patients, thus the fees are justified. I am strong believer that optometrists should be compensate for their time and extensive knowledge. At times we may cut certain fees for our long-term existing patients but patients need to understand that are our services are valuable to maintaining their vision. Although, I may not completely agree, I do respect your opinion and views on this issue.

 

[KHE]

Very interesting and clever analogy. However, doesn't everyone charge for fundus photos separately?
The doctors perform both procedures in that $35.00 charge. We explain to the patients that their eyes have to be dilated for the extended ophthalmoscopy. I could see why many people would oppose to this and it is a personal choice on how to charge patients..

Look....I'm not trying to beat you up here. I looked through some of your old postings and it seems that you work in a Lenscrafters, probably in New York. I think that that is part of what's adding to your confusion. I too worked in a Lenscrafters in New York when I was first out of school.

So again....are you SURE you understand the difference between a "dilated retinal exam" that occurs as part of a comprehensive eye exam and "extended ophthalmoscopy?" I really don't think you do.

 

[JMU07]

So again....are you SURE you understand the difference between a "dilated retinal exam" that occurs as part of a comprehensive eye exam and "extended ophthalmoscopy?" I really don't think you do.

What IS the difference? I'd like to know. Obviously a DFE is an important part of an exam and docs will do BIO or a slit lamp exam.. but what qualifies as "extended" ophthalmoscopy?

 

[optsuker]

What IS the difference? I'd like to know. Obviously a DFE is an important part of an exam and docs will do BIO or a slit lamp exam.. but what qualifies as "extended" ophthalmoscopy?

A dilated exam is for the SEARCH and should be part of most comprehensive exams. Dilating a patient just for the sake of getting a complete view of the retina is never billable separately to insurance, it's just assumed to be part of a thorough exam.

Ext Ophthalmoscopy/Billable fundus photography is for when you actually FIND pathology that needs extra attention/documentation. For most insurance carriers, it requires detailed drawing (preferably with multiple colors) and additional interpretation (both mental and documented).

Photos and Ext Opth need to have an appropriate corresponding ICD-9 code if you want it too get reimbursed.

 

[optsuker]

However, doesn't everyone charge for fundus photos separately?

Only with identified pathology.
Charging a separate fee for dilation or screening photos is almost exclusive to commercial practices (and Lenscrafters is a commericial setting). In msot cases, it's used to generate additional income for OD's who typically charge low-ball exam fees.

One exception is offices with using Optos to get an additional fee from patients who do not wish to be dilated (also not billable to insurance unless there is retinal pathology).

 

[PBEA]

Very interesting and clever analogy. However, doesn't everyone charge for fundus photos separately?
The doctors perform both procedures in that $35.00 charge. We explain to the patients that their eyes have to be dilated for the extended ophthalmoscopy. I could see why many people would oppose to this and it is a personal choice on how to charge patients.
I am not sure what insurances you may work with but they will reimburse dilation if medically necessary and appropriate. Routine visions (eyemed, VSP, spectra....) insurances never reimburse. Dilations adds time to the exam process. Time most vision insurances do not consider. We cannot make separate rules for our self-paid patients and routine vision plan patients. Therefore it is only fair if we charge for dilation separately, which many places do in medical, optometry, and even corporate offices. Unlike medical and corporate offices, our optometrists explain efficiently the results and purpose of each exam. They do great job in communicating with patients, thus the fees are justified. I am strong believer that optometrists should be compensate for their time and extensive knowledge. At times we may cut certain fees for our long-term existing patients but patients need to understand that are our services are valuable to maintaining their vision. Although, I may not completely agree, I do respect your opinion and views on this issue.

khe is correct, your commercial craptical docs do not know what they are doing. Most likely this because they have spent their career in the mall. Be forwarned, lest you fall into the same trap.........ignorance.

 

[IndianaOD]

If you are billing extended ophth all the time insurance will eat you alive. It is rarely billed. The only one I knew who ever used it was a retinal OMD I worked with and it included color pencils and more documentation. Usually for severe retinal conditions.

A 92004/14 includes routine dilation.

 

[4Eyes]

Surely they're not really billing all those extended ophth. I think I'd slit my wrists before having anything to do with that audit. Surely, if something was really that awry, they would have been audited already...?

 

[PBEA]

If you are billing extended ophth all the time insurance will eat you alive. It is rarely billed. The only one I knew who ever used it was a retinal OMD I worked with and it included color pencils and more documentation. Usually for severe retinal conditions.

A 92004/14 includes routine dilation.

not true