Visual acquity

Can we bill 99173 with E&M without 25 modifier?

99173

Vision CPT® code 99173 (screening test of visual acuity, quantitative, bilateral) is intended to be done within the same session as an E/M or Preventive Medicine service and is not separately reimbursed (CMS).
I cannot say some commercials or plans will not allow with modifier -25, but would not be often.

re: 99173

If vision screening is considered part of E&M coding or Preventive (ie sports physical/ form) and not reimbursable, can we charge a fee to the patient if they want the testing done in our office vs. optometrist office (they can bring results back to us to attach to school form instead). Ie. $10 per vision test.