E. Reason Medicare May Not Pay: Ancillary diagnostic tests of both eyes for refractive errors including low-order and higher- order optical aberrations (i.e., myopia, hyperopia, astigmatism, defocus, coma, trefoil, etc using: refractometry, wavefront aberrometry, and corneal topography. (CPT 92015, 92025)
The Medicare Benefit Policy Manual Chapter 16 §90 states:eye refractions by whatever practitioner and for whatever purpose performed are not coveredExpenses for all refractive procedures, whether performed by an ophthalmologist (or any other physician) or an optometrist and without regard to the reason for performance of the refraction, are excluded from coverage.
Prophylactic screening of both eyes for potential disorders or diseases using one or more tests such as: SCODI-A, SCODI-P, or pachymetry. (CPT 92132, 92133, 92134, 76514)
The Medicare law, Social Security Act 1862(a1) (A), does not cover any service that is not required by medical necessity " for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member."