Charges

The charges we make are: 

Description Code Cost 1st eye Cost 2nd eye
Examination 99204 / 99214 250 200
Extended retinal examination with drawing 92201 50 50
Pre-operative floater photography 92250 50 50
Laser Procedure 67299 2500 2500
TOTAL   2850 2800

 

Payment

We submit the fee for the examination, the extended retinal examination, and the photographs to your insurance company if we participate with them. We request payment at the time of service for the laser fee even though you may have insurance.  We do this because many insurance companies are not familiar with this procedure;  they do not know the judgment, expertise, skill, and especially the time needed for a successful result;and they do not know that a special laser is required that is not available to most ophthalmologists.  Also they do not know that the our one laser fee per eye covers two laser procedures for that eye.  Insurance companies have classified the procedure as experimental, investigational, and not medically necessary.  Importantly, this is a non-standard procedure, meaning there is no listed procedure code that describes it. Thus, the procedure code used is 67299-58 (“unlisted posterior segment ophthalmology procedure”). Because reimbursement is so variable from insurance companies (most paying nothing, and others paying poorly), we collect payment at the time of the procedure. At our office you will be asked to sign a form saying that the patient is responsible for the full laser fee payment.

The laser fee for an eye covers two treatments for that eye during your visit here. In the great majority of patients we need only two treatments per eye during the initial trip here, and then the case is considered finished. But if the patient has very large floaters or multiple floaters (we discuss this with the patient before starting treatment), additional treatments may be helpful. If the patient needs to come back for additional treatment, the laser fee for each additional treatment is $500 during the first three months, but there is no additional examination fee. 

After three months the fees are $200 for an examination plus $1,000 for each additional laser treatment if done.

We participate with the following insurance companies for the examination, the extended retinal examination, and the photographsInsurances We Participate With