Covered Contact Lenses/Visually Necessary Contact Lenses – Increased Maximum Allowed for Daily Replacement Lenses 

Good news! Effective January 1, 2025, VSP® will increase the allowed amounts for daily replacement lenses under the Covered Contacts and Base Visually Necessary Contact Lens maximums by 15 to 20%. These changes will apply to claims with dates of service starting January 1, 2025, and going forward.  

To maximize your patient’s benefit, and ensure proper payment, dispensing an annual supply of contacts at one time is required under the Covered Contact Lenses and Necessary Contact Lenses benefits. Bill the total number of units provided based on the type of lenses dispensed. Do not balance bill your patient for the difference between your U&C fee and our allowable amount. 

For additional coverage information, visit the Provider Reference Manual by logging into eyefinity.com and selecting VSPOnline. Once logged in, select the Manuals option on the left side of the page and click the VSP network. The Contact Lens Benefit section includes the Maximum Allowable table and claim submission instructions. This information can also be accessed from the Materials Coverage section of the Choice and Advantage network.