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92235 Medicaid reimbursement rates by state

Eye exams and vision services. 25 state Medicaid programs publish a fee-for-service rate for 92235 at the physician psychologist level. Rates run from $31.68 in New York to $167.48 in Arizona, with a median of $67.98.

Data as of 2026-10-05. Every rate links to the official document it came from.

States publishing
25
Median rate
$67.98units vary by state
Highest
$167.48Arizona
Medicare (non-facility)
$143.37–$225.382026 physician fee schedule

92235 rate in every state

One like-for-like fee-for-service rate per state, highest first. Units can differ between states; the per-hour column converts time-based units.

StateMedicaid rateUnitPer hourManaged-care plans% of MedicareSource
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$167.48since 2026-10-01——Plans negotiate; applies out of network—AHCCCS Arizona Health Care Cost Containm
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$104.46since 2026-07-01——Plans negotiate; applies out of network—DMAS procedure fee file cptmedical4.csv
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$103.35since 2026-01-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$100.73since 2024-04-01——Plans negotiate; applies out of network—HFS Practitioner Fee Schedule (effective
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$95.20since 2026-02-01——Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$81.73since 2026-10-01——Plans negotiate; applies out of network—Medi-Cal Rates (Rates files zip: rates_d
FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service)$78.03since 2026-01-01——Plans negotiate; applies out of network—Practitioner Fee Schedule (2026-01-01)
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$77.04since 2024-07-01——Not classified—SCDHHS Base Physician Fee Schedule (sche
MichiganIndependent (non-agency) provider · Michigan Medicaid (fee-for-service)$76.89since 2026-01-01——Plans negotiate; applies out of network—MDHHS Independent Diagnostic Testing Fac
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$76.27since 2026-10-01——Plans negotiate; applies out of network—Emergency Adoption (date filed: Septembe
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$76.06since 2026-07-01——Plans negotiate; applies out of network—HCA Physician-related services fee sched
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$68.33since 2020-01-01——Plans negotiate; applies out of network—KY Medicaid Physician fee schedule (2020
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$67.98since 2009-10-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Medical-
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$65.80since 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$62.55since 2022-07-01——Plans negotiate; applies out of network—MO HealthNet fee schedule: Radiology - T
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$62.27since 2026-01-01——Not classified—Maryland Medicaid Professional Services
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$57.66since 2025-10-01——Plans negotiate; applies out of network—NC Medicaid fee schedule 'Independent Di
TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP)$56.13since 2025-03-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Physi
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$53.75since 2024-01-01——Plans negotiate; applies out of network—Appendix DD to OAC 5160-1-60 (Non-Instit
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$46.66since 2017-01-01——Plans negotiate; applies out of network—Physician Maximum Allowed Fee Schedule -
LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service)$45.33since 2026-01-01——Plans must pay at least this—Louisiana Medicaid Enhanced Professional
PennsylvaniaPhysician or licensed psychologist (incl. BCBA-D) · Pennsylvania Medical Assistance (fee-for-service)$40.09since 2012-09-12——Plans negotiate; applies out of network—PA DHS PROMISe Outpatient Fee Schedule (
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$38.76since 2014-07-01——Not classified—NJMMIS Procedure Master Listing children
ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP)$37.49since 2026-07-01——Plans negotiate; applies out of network—Child Health Plan Plus FY 2026-2027 Fee
New YorkPhysician or licensed psychologist (incl. BCBA-D) · New York Medicaid (fee-for-service)$31.68since 2025-04-01unit—Plans negotiate; applies out of network—eMedNY Physician Fee Schedule Sect 2 (Me

Rates are per the unit shown for each state; units can differ between states. Medicare amounts are computed from the CMS relative value file and locality cost indices with the CMS formula; states with several Medicare localities show a range. Confirm rates with the payer before billing.

Frequently asked questions

What does Medicaid pay for 92235?

It depends on the state. Of the 25 states with a published fee-for-service rate, the median is $67.98. Arizona pays the most ($167.48) and New York the least ($31.68 per unit).

Which state pays the highest Medicaid rate for 92235?

Arizona, at $167.48, effective 2026-10-01.

Do managed-care plans pay the same rate for 92235?

Not necessarily. Each state's plan contracts decide whether plans must pay at least the fee-for-service rate, pay a state-set rate, or negotiate their own. The table shows the rule for each state, cited to the contract or statute.

Related Vision & hearing codes

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