; coinsurance; and limitations (1) In general Section 1833(a)(1) of the Social Security Act ( 42 U.S.C. 1395l(a)(1) ) is amended— (A) by striking and before (CC) ; and (B) by inserting before the semicolon at the end the following: , and (DD) with respect to vision services (as defined in section 1861(kkk)), the amount paid shall be equal to 80 percent of the lesser of the actual charge or the amount determined under the payment basis determined under section 1848 . (2) Limits specified Section 1834 of the Social Security Act ( 42 U.S.C. 1395m ) is amended by adding at the end the following new subsection: (x) Limitation for vision services With respect to vision services (as defined in section 1861(kkk)) and an individual, payment may be made under this part for only 1 routine eye examination described in paragraph (1) of such section and 1 contact lens fitting service described in paragraph (2) of such section during a 2-year period. . (d) Payment under physician fee schedule (1) In general Section 1848(j)(3) of the Social Security Act ( 42 U.S.C. 1395w–4(j)(3) ) is amended by inserting (2)(II), before (3) . (2) Budget neutrality Section 1848(c)(2)(B)(iv) of the Social Security Act (42 U.S.C. 1395–w(c)(2)(B)(iv)) is amended— (A) in subclause (III), by striking and at the end; (B) in subclause (IV), by striking the period at the end and inserting ; and