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CPT 99173: Pediatric Visual Acuity Screening

CPT code 99173 denotes a pediatric visual acuity screening using a standard distance chart (for example, a Snellen chart) held 20 feet from the patient to assess both eyes. This brief, office-based assessment helps identify refractive errors, amblyopia risk, or other vision concerns early in childhood; timely detection can affect developmental, educational, and sight-preservation outcomes. Nationally, this screening is commonly performed in pediatric and primary care settings and is relevant to preventive health workflows and pediatric quality measures.

Key payers in the national analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context, common sites of service, and where 99173 fits into routine pediatric preventive care. The publication also outlines benchmarking and policy-relevant considerations for payers and administrators, including coverage posture variations and typical use cases for office- or school-based screenings. Where input data is missing, the text notes that specific payer policies or utilization benchmarks are not available in the source material.

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Billing Code Overview

CPT code 99173 describes a pediatric visual acuity screening in which the provider assesses the eyesight of both eyes by asking the child to read letters of varying sizes on a standard chart (for example, a Snellen chart) held 20 feet from the patient. This procedure evaluates distance visual acuity and is focused on pediatric patients.

Service type: Visual acuity screening / pediatric eye screening
Typical site of service: Outpatient clinic, primary care office, pediatric office, or school-based health setting

Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.

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Find policies, billing codes, payers, states, and providers

CPT 99173: Pediatric Visual Acuity Screening

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Billing Code Overview

Service type: Visual acuity screening / pediatric eye screening
Typical site of service: Outpatient clinic, primary care office, pediatric office, or school-based health setting

Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.

Clinical & Coding Specifications

Clinical Context

A 5-year-old child presents to a primary care pediatric clinic for a well-child visit. The nurse rooming the patient performs a visual acuity screening using a standardized distance chart (for example, a Snellen chart) positioned approximately 20 feet from the child. The examiner asks the child to read letters of progressively smaller sizes for each eye, then both eyes together, documenting the smallest line read reliably and whether testing was performed monocularly with occlusion. If the child cannot reliably read letters, age-appropriate symbols or tumbling E chart may be used and documented. Test results are recorded in the medical record and reviewed by the pediatrician; abnormal findings prompt referral to pediatric ophthalmology or optometry. The encounter typically occurs in the outpatient clinic exam room but may also occur in school-based health screenings or community well-child screening events.

Coding Specifications

Modifier	Description	When to Use
`25`	Significant, separately identifiable evaluation and management service by the same provider on the same day	Use when a separately identifiable office visit/E&M is performed in addition to the screening vision test.
`26`	Professional component	Use when only the professional component of a split-billed service is reported (rare for this screening).
`59`	Distinct procedural service	Use when the vision screening is distinct from another procedure performed the same day and not normally reported together.
`76`	Repeat procedure by same provider	Use when the same provider repeats the screening on the same day for medical reasons.
`77`	Repeat procedure by another provider	Use when a different provider repeats the vision screening the same day (note: `77` not in provided list; excluded).
`91`	Repeat clinical diagnostic laboratory test	Not applicable to vision screening; included in list but generally not used for this CPT.
`52`	Reduced services	Use when the screening is partially performed or truncated for clinical reasons.
`53`	Discontinued procedure	Use when the screening is started but terminated due to patient condition or behavior.
`59`	Distinct procedural service	(See above)
`TC`	Technical component	Use when only equipment/technical portion is billed separate from professional interpretation (rare for manual chart testing).

Taxonomy Code	Specialty	Notes
`207RP0210X`	Pediatric Medicine	Pediatricians routinely perform pediatric vision screening during well-child visits.
`207RG0300X`	Family Medicine	Family physicians conduct pediatric screenings in primary care settings.
`174400000X`	Ophthalmology	Ophthalmologists perform comprehensive eye exams and follow-up when screenings are abnormal.
`152W00000X`	Optometry	Optometrists provide diagnostic refraction and follow-up eye care after referral.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
Data not available in the input.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`99173`	Screening test of visual acuity, pediatric, by standardized chart	Primary procedure: distance visual acuity screening using a chart at 20 feet.
`92002`	Ophthalmological services: medical examination and evaluation, new patient, intermediate, without detailed diagnosis (new patient)	Performed when an abnormal screening prompts an initial ophthalmology evaluation.
`92012`	Ophthalmological services: medical examination and evaluation, established patient, intermediate	Follow-up comprehensive eye exam in ophthalmology or optometry after abnormal screening.
`99174`	Instrument-based ocular screening (e.g., photoscreening) for amblyopia risk factors, pediatric	Alternate pediatric vision screening method often used for nonverbal or younger children.
`99177`	Ophthalmic screening for drug-induced visual impairment	Not routine but can be performed in specific clinical contexts; listed as related screening services.

CPT 99170: Forensic Pediatric Sexual Abuse Examination with Microscopy

CPT-99172-FUNCTIONAL-VISION-ASSESSMENT-JOB-FITNESS

CPT 99172: Functional Vision Assessment for Job Fitness

CPT-99174-VISION-SCREENING-BOTH-EYES-INSTRUMENT-BASED

CPT 99174: Instrument-Based Vision Screening of Both Eyes

CPT-99175-EMETIC-ADMINISTRATION-FOR-INGESTED-POISONING

CPT 99175: Emetic Administration for Ingested Poisoning

CPT-99177-INSTRUMENT-VISION-SCREENING-BOTH-EYES

CPT 99177: Instrument-Based Vision Screening and Analysis, Both Eyes

CPT-99183-HYPERBARIC-OXYGEN-THERAPY-SUPERVISION

CPT 99183: Supervision of Hyperbaric Oxygen Therapy

CPT-99184-NEONATAL-THERAPEUTIC-HYPOTHERMIA-TEMPERATURE-MANAGEMENT

CPT 99184: Neonatal Therapeutic Hypothermia with Esophageal Temperature Monitoring

CPT-99188-FLUORIDE-ADHESIVE-APPLICATION-TOOTH-SURFACE

CPT 99188: Fluoride Adhesive Application to Tooth Surface

CPT-99190-PERFUSION-PUMP-OXYGENATOR-OPERATION

CPT 99190: Perfusion Pump–Oxygenator Operation, Hourly

CPT-99191-PUMP-OXYGENATOR-EXTRACORPOREAL-CIRCULATION-45MIN

CPT 99191: Pump–Oxygenator/Heat Exchanger Operation, 45 Minutes

Showing 1–10 of 13

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

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Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

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Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`25`	Significant, separately identifiable evaluation and management service by the same provider on the same day	Use when a separately identifiable office visit/E&M is performed in addition to the screening vision test.
`26`	Professional component	Use when only the professional component of a split-billed service is reported (rare for this screening).
`59`	Distinct procedural service	Use when the vision screening is distinct from another procedure performed the same day and not normally reported together.
`76`	Repeat procedure by same provider	Use when the same provider repeats the screening on the same day for medical reasons.
`77`	Repeat procedure by another provider	Use when a different provider repeats the vision screening the same day (note: `77` not in provided list; excluded).
`91`	Repeat clinical diagnostic laboratory test	Not applicable to vision screening; included in list but generally not used for this CPT.
`52`	Reduced services	Use when the screening is partially performed or truncated for clinical reasons.
`53`	Discontinued procedure	Use when the screening is started but terminated due to patient condition or behavior.
`59`	Distinct procedural service	(See above)
`TC`	Technical component	Use when only equipment/technical portion is billed separate from professional interpretation (rare for manual chart testing).

Taxonomy Code	Specialty	Notes
`207RP0210X`	Pediatric Medicine	Pediatricians routinely perform pediatric vision screening during well-child visits.
`207RG0300X`	Family Medicine	Family physicians conduct pediatric screenings in primary care settings.
`174400000X`	Ophthalmology	Ophthalmologists perform comprehensive eye exams and follow-up when screenings are abnormal.
`152W00000X`	Optometry	Optometrists provide diagnostic refraction and follow-up eye care after referral.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
Data not available in the input.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`99173`	Screening test of visual acuity, pediatric, by standardized chart	Primary procedure: distance visual acuity screening using a chart at 20 feet.
`92002`	Ophthalmological services: medical examination and evaluation, new patient, intermediate, without detailed diagnosis (new patient)	Performed when an abnormal screening prompts an initial ophthalmology evaluation.
`92012`	Ophthalmological services: medical examination and evaluation, established patient, intermediate	Follow-up comprehensive eye exam in ophthalmology or optometry after abnormal screening.
`99174`	Instrument-based ocular screening (e.g., photoscreening) for amblyopia risk factors, pediatric	Alternate pediatric vision screening method often used for nonverbal or younger children.
`99177`	Ophthalmic screening for drug-induced visual impairment	Not routine but can be performed in specific clinical contexts; listed as related screening services.

CPT 99170: Forensic Pediatric Sexual Abuse Examination with Microscopy

CPT-99172-FUNCTIONAL-VISION-ASSESSMENT-JOB-FITNESS

CPT 99172: Functional Vision Assessment for Job Fitness

CPT-99174-VISION-SCREENING-BOTH-EYES-INSTRUMENT-BASED

CPT 99174: Instrument-Based Vision Screening of Both Eyes

CPT-99175-EMETIC-ADMINISTRATION-FOR-INGESTED-POISONING

CPT 99175: Emetic Administration for Ingested Poisoning

CPT-99177-INSTRUMENT-VISION-SCREENING-BOTH-EYES

CPT 99177: Instrument-Based Vision Screening and Analysis, Both Eyes

CPT-99183-HYPERBARIC-OXYGEN-THERAPY-SUPERVISION

CPT 99183: Supervision of Hyperbaric Oxygen Therapy

CPT-99184-NEONATAL-THERAPEUTIC-HYPOTHERMIA-TEMPERATURE-MANAGEMENT

CPT 99184: Neonatal Therapeutic Hypothermia with Esophageal Temperature Monitoring

CPT-99188-FLUORIDE-ADHESIVE-APPLICATION-TOOTH-SURFACE

CPT 99188: Fluoride Adhesive Application to Tooth Surface

CPT-99190-PERFUSION-PUMP-OXYGENATOR-OPERATION

CPT 99190: Perfusion Pump–Oxygenator Operation, Hourly

CPT-99191-PUMP-OXYGENATOR-EXTRACORPOREAL-CIRCULATION-45MIN

CPT 99191: Pump–Oxygenator/Heat Exchanger Operation, 45 Minutes

Showing 1–10 of 13

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

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CPT 99173: Pediatric Visual Acuity Screening

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Billing Code Overview

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CPT 99173: Pediatric Visual Acuity Screening

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Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

CPT 99173: Pediatric Visual Acuity Screening

Sign up for cpt 99173 policy alerts

Billing Code Overview

CPT 99173: Pediatric Visual Acuity Screening

Sign up for cpt 99173 policy alerts

Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What does CPT 99173 represent and where is this screening usually performed?

What clinical details should be documented when performing 99173?

Which modifiers are commonly associated with 99173 and when would modifier 25 be used?

What related CPT codes should I consider if a screening is abnormal or an alternate screening method is used?

Which payers are mentioned for 99173 and where can I find coverage specifics?

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What does CPT 99173 represent and where is this screening usually performed?

What clinical details should be documented when performing 99173?

Which modifiers are commonly associated with 99173 and when would modifier 25 be used?

What related CPT codes should I consider if a screening is abnormal or an alternate screening method is used?

Which payers are mentioned for 99173 and where can I find coverage specifics?

References