Connecticut doctors of optometry have secured Medicaid payment parity with ophthalmologists for four high-volume services following sustained advocacy by the Connecticut Association of Optometrists (CAO).
Effective July 1, 2026, reimbursement for the four services increased 10%, providing an estimated additional $2.27 million in Medicaid payments to optometric providers, including $1.42 million in federal funding.
According to the American Optometric Association, the change addresses a reimbursement disparity under which optometrists received lower Medicaid payments than ophthalmologists for providing the same services.
Four High-Volume Services
The 10% increase applies to four codes that together account for more than 85% of total optometric Medicaid billings: comprehensive eye examinations for new patients (92004), comprehensive eye examinations for established patients (92014), refraction (92015), and fundus photography (92250).
According to the AOA, doctors of optometry performed 167,384 Medicaid patient eye exams in 2025, representing 88.6% of the total, compared with 21,394 Medicaid patient exams performed by ophthalmologists.
Nearly nine in 10 CAO members already treat Medicaid patients. The association expects participation to increase to 93% following the reimbursement change, potentially expanding the number of providers available to Medicaid patients and increasing access to care.
Addressing a Reimbursement Disparity
The new rates follow CAO advocacy calling for optometrists and ophthalmologists to receive equal Medicaid reimbursement when providing the same services. Connecticut’s legislative analysis specifically required reimbursement rates for licensed optometrists to equal those of ophthalmologists for the same medical service or procedure.
“Optometry was the sole medical profession singled out for a special reimbursement increase in Medicaid this year. Better fees will help increase access to critical vision care services for Medicaid patients in our state,” says Brian Lynch, OD, CAO legislative chair.