Only 16% of California's Medi-Cal Kids Got an Eye Exam — as the $47 Optometry Rate Stays Frozen for 25 Years and the May Revision Leaves Optometry Out of Its Rate Increases

CalMatters reports that just 16% of California children on Medi-Cal received an eye exam in 2022–2024, down from 19% eight years earlier, with nearly every county declining. The driver is reimbursement: Medi-Cal pays ~$47 for a comprehensive eye exam — unchanged in 25 years — so only ~10% of California Optometric Association members accept Medi-Cal, 10% dropped it in the past two years, and 40% of non-participating ODs cite the low rate. Compounding it, the California Optometric Association confirms (Jan 12, 2026) that the Governor's May Revision provider rate increases explicitly EXCLUDE optometric exams — resolving a previously unsourced concern. For FQHCs this is both a gap and an opening: centers carry EPSDT vision obligations for pediatric Medi-Cal patients that private ODs increasingly won't serve, so demand concentrates on FQHC vision programs and on the higher-margin AI diabetic-retinopathy code (CPT 92229, ~$50 Medicare / ~$100 commercial) that primary-care staff can bill without an on-site optometrist. Pairs with the already-tracked AB 2756 Medi-Cal vision quality-reporting bill — together they make children's eye care a measurable, rate-driven access problem FQHCs are positioned to absorb.