Eye Refractions Billing & Cost

One of the most basic parts of an eye exam is checking the refraction of your eyes or an eye refraction test. This allows us to determine what your best possible vision is at that point in time while wearing a prescription optical lens and gives us the basis for prescribing a prescription optical lens. The most common type of eye refraction is called a Manifest Refraction and is performed without the use of eye drops so that we can examine the eye in a natural state. If you have ever had an eye exam, you are probably familiar with the “which is better, one or two” test-this is a manifest refraction.

Another type of eye refraction is called a cycloplegic refraction which is performed after the instillation of eye drops to temporarily immobilize the ciliary muscle of the eye. This temporarily prevents you from accommodating or “focusing” up close and is used when there is a need for an even more precise measurement of refractive error. In addition, the eye drops will also dilate the pupil so the eye doctor can easily see the back of the eye to examine the retina, optic nerve and blood vessels in order to evaluate their health.

From an insurance standpoint, eye refractions are considered part of a routine eye exam. Because refractions are normally used to determine refractive errors such as myopia, hyperopia, and astigmatism, and therefore prescribe eyeglasses or contact lenses, many insurance companies, particularly Medicare and Medicaid, do not pay for them. It's important to understand that when patients are having their eye exam, refractions are a necessary part of a routine eye exam and must be paid for out of pocket.

If you have questions about the cost of your refraction, or billing questions about refraction, please call D’Ambrosio Eye Care at 800-325-3937 and we will be glad to assist.