Insurance and out-of-network benefits.
Hope Vision is a fee-for-service practice. We don't bill or submit claims to insurance. If your medical insurance offers out-of-network benefits, we'll give you everything you need to submit a claim yourself.
Three steps to submit your own claim.
Check your benefits
Call your medical insurance company and ask whether you have out-of-network benefits, and what their process is to submit a claim.
Pay at your visit
Payment is due at the time of service. We don't bill insurance or submit claims for you.
Submit your claim
We provide a statement with CPT and diagnosis codes, and a letter of medical necessity, for you to submit to your insurance.
Share these codes with your insurance.
Your insurance company may ask for the CPT codes for the services you plan to receive. Diagnosis codes depend on your evaluation findings and appear on your statement.
| Service | CPT code(s) |
|---|---|
| Binocular Vision Evaluation | 9920392060 |
| Visual Processing Testing | 96112 |
| Vision Therapy | 92066With a vision therapist92065With Dr. Toler |
| Progress Exams | 99213 |
Common diagnosis codes we see.
These ICD-10 diagnosis codes are among those we see most often. Your diagnosis codes are based on your evaluation findings and will be listed on your statement.
| ICD-10 code | Description |
|---|---|
| H51.11 | Convergence insufficiency |
| H52.523 | Paresis of accommodation, bilateral (focusing problem) |
| H55.81 | Saccadic eye movements (eye tracking problem) |
| H55.89 | Other irregular eye movements |
| H53.30 | Disorder of binocular vision, unspecified |
| R41.9 | Symptoms involving cognitive functions and awareness, unspecified |
| H53.021H53.022 | Refractive amblyopia (lazy eye), right eye / left eye |
| H50.34 | Intermittent alternating exotropia (eye turns outward) |
| H50.331H50.332 | Intermittent monocular exotropia, right eye / left eye |
Please note: your diagnosis codes may differ. This is for educational purposes only and does not imply coverage of any kind.
Diagnosis codes and coverage.
We can't change diagnosis codes
Your diagnosis codes reflect your evaluation findings. We're unable to change diagnosis codes because of insurance coverage.
We don't imply coverage
We do not imply coverage for any diagnosis code, CPT code or insurance provider. Coverage and reimbursement are decided by your insurance plan.
Please contact your insurance
Your insurance company is the only one who can tell you what your plan covers and how to submit a claim.
Questions to ask your insurance
- Do I have out-of-network benefits for these CPT codes?
- What is my out-of-network deductible, and how much have I met?
- What percentage is reimbursed once the deductible is met?
- Do I need a referral or prior authorization?
- How do I submit a claim, and which form do you need?
- Is there a deadline to submit claims?
What we can provide for your claim
- A receipt or statement of services provided, with CPT and diagnosis codes
- A letter of medical necessity
Ask our Patient Care Coordinator at pcc@hopevdc.com or 352-243-4673.
Our fees
See current prices for evaluations, vision therapy and progress exams.
See programs and fees →Using FES-UA funds?
We're an approved provider for the Family Empowerment Scholarship for Students with Unique Abilities (FES-UA) through Step Up For Students.
How to reserve your FES-UA funds →Insurance questions
Do you accept insurance?
Hope Vision is a fee-for-service practice. We don't bill or submit claims to medical or vision insurance. Payment is due at the time of service.
Can I get reimbursed by my insurance?
Some medical insurance plans offer out-of-network benefits. Check with your medical insurance company about your benefits and their process for submitting a claim. Coverage and reimbursement are decided by your plan.
Which CPT codes do you use?
Binocular Vision Evaluation: 99203 and 92060. Visual Processing Testing: 96112. Vision therapy: 92066 with a vision therapist or 92065 with Dr. Toler. Progress exams: 99213.
What diagnosis codes do you use?
Diagnosis codes depend on your evaluation findings. Common codes we see include H51.11, H52.523, H55.81, H55.89, H53.30, R41.9, H53.021, H53.022, H50.34, H50.331 and H50.332. Your diagnosis codes may differ. This is for educational purposes only and does not imply coverage of any kind.
Can you change my diagnosis code so my insurance will cover it?
No. Your diagnosis codes reflect your evaluation findings, and we're unable to change diagnosis codes because of insurance coverage. We do not imply coverage for any diagnosis code or insurance provider. Please contact your insurance.
What do you provide for my claim?
We can provide a receipt or statement of services with CPT and diagnosis codes, and a letter of medical necessity.
Does vision insurance cover vision therapy?
Vision plans usually cover routine eye exams and glasses. Out-of-network benefits for evaluations and vision therapy, if any, are usually through your medical insurance. Ask your plan to be sure.
Can I use FES-UA scholarship funds?
Yes. We're an approved provider for the Family Empowerment Scholarship for Students with Unique Abilities (FES-UA) through Step Up For Students.
Questions about insurance?
Our Patient Care Coordinator is happy to help you understand the paperwork we can provide for your claim.