Orthoptic Vision Therapy

Aetna covers orthoptic vision therapy only for convergence insufficiency (ICD‑10 H51.11–H51.12, H51.8) — CPT 92065/92066 are payable if selection criteria are met for up to 12 visits, after which additional visits require medical review, and members should be transitioned to a home exercise program (e.g., pencil push‑ups); occlusion (patching) is medically necessary for amblyopia (passive orthoptic/pleoptic devices are outside this CPB’s scope). Orthoptic therapy (including digital/online systems such as CureSight or RevitalVision) is considered experimental/investigational and not covered for amblyopia or any other indications beyond convergence insufficiency (e.g., anisometropic amblyopia, concussion, diplopia post‑orbital fracture, intermittent exotropia, TBI, vertical heterophoria).

"Orthoptic vision therapy is considered medically necessary for treatment of convergence insufficiency (up to 12 orthoptic vision therapy visits or sessions)."