contact lens practice pearls

Comprehensive Exam Fees for CL Wearers

contact lens practice pearls
Comprehensive Exam Fees for CL Wearers

"Hey Mac, while you're changing the oil, can you also rotate the tires? There won't be an additional charge for that, right?" Wrong! No auto service center would stay in business if it didn't charge for the services it provided. Likewise, not many people would offer a service and not expect compensation.

Interestingly, many contact lens providers do just that when they perform comprehensive examinations. However, the first step in being a financially successful contact lens practitioner is: If you provide a contact lens-related service, charge for it.

Why We Should Charge

Too often we lump contact lens services together with other eye care services. We invest our time and expertise without realizing any financial gain. Now think about additional testing you perform on contact lens patients along with a comprehensive exam. We ask for clarification of onset, frequency and severity of symptoms. We may need to review wearing schedules, care systems and medications to understand a patient's problem and solve it.

Invariably, additional tests (such as those listed in Table 1) will be indicated even on asymptomatic patients, and this investment of time and expertise deserves compensation.

Why We Don't Charge

Many of us lump spectacle and contact lens wearers under one exam fee for fear of losing the patient from sticker shock. But think about it from your own consumer perspective. How did you choose your general physician or dentist?

Most people base their choices on whom they trust with their health. In fact, most of your patients will choose you because they trust you with their sight. Money isn't the deciding factor when it comes to health.


TABLE 1 Charge for Tests Such as Those Listed Below that Fall Outside of the Comprehensive Exam Fee


  • Contact lens-related history

  • Visual acuity with lenses

  • Over-refraction

  • Lens fit assessment

  • Detailed slit lamp exam

  • Lid eversion

  • Keratometry

  • Topography

Converting From Free to a Fee

Once you understand that you should charge higher fees for a comprehensive contact lens exam, how do you implement these new fees? We undertook just such a project about 15 years ago.

When scheduling an appointment, if the patient is a contact lens wearer, then instruct him to wear his lenses to the exam and explain that you'll perform additional testing to ensure safe and effective wear.

If you're dealing with an established patient who hasn't had to pay added costs in the past, then mention the additional costs associated with testing to check the safety and fit of the lenses.

When scheduling a new patient, feel free to mention the additional tests, but you don't have to bring up the additional fee unless he inquires about costs. Most patients understand that additional services come with additional fees.

When insurance questions arise, explain that "Insurance doesn't pay for contact lens services because they're (in most cases) elective." This additional fee is usually a bigger adjustment for the doctor and his staff than for his patients.

Every Bit Helps

Comprehensive exams are our bread and butter. Adjusting our lens fees, even slightly, has a huge impact on the bottom line -- and it makes sense. Just ask Mac.

Dr. Quinn is in group practice in Athens, Ohio, and has served as a faculty member at The Ohio State University College of Optometry.