July 15, 2013

State of Alabama
Press Release: Medicaid

Coverage of Visual Evoked Potential (VEP)

TO:  All Optometrists and Ophthalmologists

Currently, the Alabama Medicaid Agency covers VEP only for neurologists. Effective for dates of service on or after August 1, 2013, Medicaid will also cover VEP for optometrists and ophthalmologists. 

To bill for VEP, the provider must use the following CPT® procedure code:

·         95930 – Visual Evoked Potential (VEP) Testing Central Nervous System

 

If the provider owns the equipment and performs the reading, then procedure code 95930 would be billed without a modifier. This is called a global service.

 

If the provider does not own the equipment, but performs the reading, then procedure code 95930 must be billed with modifier 26. This is called a professional interpretation service.

 

The current reimbursement rate for 95930 is:

·         $65.00 for the global

·         $17.00 for the professional interpretation

 



  • For more information, visit http://medicaid.alabama.gov
  • For more state-wide press releases, click here