S0621 Routine ophthalmological exa

Routine ophthalmological examination including refraction; established patient

Medicare pricing for S0621

Physician Fee Schedule (CY 2026, RVU26D)

Status I: not valid for Medicare (Medicare uses another code).

Payer policies and prior authorization for S0621

Payer coverage policies that name S0621

S0621 appears in 1 coverage policy from Blue Cross & Blue Shield of Rhode Island.

PayerPolicyRole in policyReviewedDocument
Blue Cross & Blue Shield of Rhode IslandOphthalmology Examination and Routine Eye Examcovered if criteria are metMar 6, 2024payer document

Medicaid fee-for-service

Prior authorization required or conditional in IN.

  • ND: $0.00 (physician), effective Aug 1, 2026
  • TX: $74.94 (miscellaneous_other_professionals_optician, Miscellaneous Other Professionals - Optician, non-facility), effective Sep 1, 2023

From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.