Effective, November 10, 2011, the VER/VEP tests will not be reimbursed separately when provided by a primary care provider for a MedStar Family Choice Member. VEP or VER testing code 95930 will only be covered by MedStar Family Choice if performed by a participating Neurologist or Pediatric Neurologist. Claims submitted by any other specialties will be denied.
It is important to note:
- Visual Evoked Response or Potential Tests are not recommended as an objective vision screening test in the EPSDT recommendations or Federal mandates and is not intended as a screening test.
- As per the EPSDT Program, children up to five years of age must be assessed for vision impairments through: Health history, physical examination and gross subjective assessment. In addition, objective vision tests are also recommended at ages 4-6 yrs, 12 yrs, 15 yrs and 18 years of age.
For additional information on this topic, please contact the MedStar Family Choice Provider Relations Department at 1-855-210-6203 or fax to 1-202-243-5497.