Reminder for Vision Value Add: XU Modifier Required for Hardware and Fit/Dispense
Date: 04/18/24
Oklahoma Complete Health offers two vision related Value Added Benefits:
- Adults age 21+ receive a complete eye exam with refraction every year (service date to service date) and $150 towards the cost of glasses or contact lenses every two years.
- Foster Care members receive an additional $100 allowance annually for deluxe frames or contact lenses. Value added benefit claims for hardware or contact lenses must be submitted with the XU modifier on each service line that is intended to be paid under the member annual allowance. In addition, Foster Care members receive unlimited replacements.
* Value Add CL Fitting and Glasses Dispense are paid separately from the member allowance
| Codes | Value Add Modifier | Description |
| V2020-V2025 | XU Modifier | Frames |
| V21xx, V22xx, V23xx | XU Modifier | Prescription Lenses |
| V2500-V2599, S0500 | XU Modifier | Contact Lenses |
| V2700-V2799 | XU Modifier | Lens Add Ons |
| 92310 | XU Modifier | Value Add CL Fitting* |
| 92340-92342 | XU Modifier | Value Add Glasses Dispense* |