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Billing code V2199 · Vision & hearing

V2199 Medicaid reimbursement rate by state (2026)

Not otherwise classified, single vision lens. Medicaid pays a median of $38.69 for V2199 across 8 states, from $10.50 in New Hampshire to $105.00 in Wisconsin.

Data as of Oct 5, 20268 statesEvery rate links to its official source

States publishing
8
National median
$38.69units vary by state
Lowest
$10.50New Hampshire
Highest
$105.00Wisconsin
Answer

What does Medicaid pay for V2199?

8 state Medicaid programs publish a fee-for-service rate for V2199. The national median is $38.69 (units differ between states). Wisconsin pays the most, $105.00, and New Hampshire the least, $10.50, a 10.0x spread.

State ranking

V2199 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 8 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Wisconsin Source · since 2025-09-01$105.00——Plans negotiate; applies out of network—
2Idaho Source · since 2018-10-01$99.00——Not classified—
3Hawaii Source · since 2024-03-04$52.00——Plans negotiate; applies out of network—
7South Carolina Source · since 2014-01-01$16.92——Not classified—
8New Hampshire Source · since 2025-07-01$10.50——Plans negotiate; applies out of network—
See all 8 states for V2199 — start free

3 more states, with every modifier and provider-type variant, rate history and the plan rule in each state. 14-day free trial, no credit card.

  • Source for every rate
  • Full rate history
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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; states with several Medicare localities show a range. Confirm rates with the payer before billing.

Track V2199 in your states. Get an alert when any state changes it, with every variant and the managed-care rule.
Guide

How to read this table

  • Order. States are listed from the highest published rate to the lowest. No single unit is shared by 8 or more states for V2199, so the order is by published amount and is not a like-for-like rank.
  • Medicaid rate. The most the state's fee-for-service program pays for one unit, as published. 1 of the 8 states list more than one rate for V2199, by modifier, provider type or setting; the table shows the one that matches the provider level and setting used across states, without add-ons.
  • Unit. None of the 8 schedules prints a separate unit for V2199, so each amount is a flat payment for one service as the code defines it.
  • Per hour. V2199 is not billed in time units in these states, so no hourly figure is shown.
  • Managed-care plans. The rule the state sets for its plans on this rate. What each rule means is explained below.
  • % of Medicare. No Medicare physician fee schedule amount is on file for V2199, so there is no percentage.
  • Source and date. Each Source link opens the state's own document; “since” is the date the rate took effect.
Context

Why V2199 rates differ between states

Published rates for V2199 run from $10.50 in New Hampshire to $105.00 in Wisconsin, a 10.0x gap in the same unit. Half the states pay more than the median of $38.69 and half pay less. The usual reasons for a spread like this in vision & hearing rates:

  • Some states buy eyeglasses through a single contracted laboratory, which changes what a provider is paid for the materials.
  • Hearing aids and some lenses are priced at invoice or acquisition cost in some states and at a fixed fee in others.
  • Adult vision and hearing benefits are optional for states, so coverage, limits and fees vary widely.

Timing matters too. 2 states set the current rate for V2199 in 2026 or later, while 3 states still pay a rate that took effect in 2022 or earlier. A state that has not updated its rate in years will drift down the ranking as others raise theirs.

Managed care

What managed-care plans pay for V2199

No managed-care plan publishes what it pays for V2199. What is public is the rule each state's plan contracts set, and that rule decides how much the published rate matters when you contract with a plan.

In 5 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 3 states is not classified yet.

  • Plans negotiate; the published rate applies out of network (5 states). In-network rates can be above or below the published rate. The published rate is the benchmark both sides know, and the fallback if no contract is signed.

Plan-negotiated rates are never estimated here. To see the rule and its citation for a particular state, open that state's managed-care page, for example Wisconsin managed care.

Billing

Units and billing for V2199

V2199 is a HCPCS Level II vision, hearing and speech code in the vision & hearing line, billed mostly by optometrists, opticians, audiologists and hearing aid dispensers. V codes cover lenses, frames, prosthetic eyes, hearing aids and related services, generally paid per item and per side.

Vision and hearing materials are billed per item, per lens or per device, and hearing aids per ear (monaural or binaural).

Before billing, confirm the rate, unit and any modifier with the state's current schedule or the plan: the amounts here are as published, not a guarantee of payment.

FAQ

Frequently asked questions

What does Medicaid pay for V2199?

It depends on the state. Of the 8 states with a published fee-for-service rate, the median is $38.69. Wisconsin pays the most ($105.00) and New Hampshire the least ($10.50).

Which state pays the highest Medicaid rate for V2199?

Wisconsin, at $105.00, effective 2025-09-01.

Which state pays the lowest Medicaid rate for V2199?

New Hampshire, at $10.50, effective 2025-07-01.

What unit is V2199 billed in?

None of the 8 schedules prints a separate unit for V2199, so each amount is a flat payment for one service as the code defines it.

Do managed-care plans pay the same rate for V2199?

Not necessarily. In 5 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 3 states is not classified yet. Each rule is cited to the plan contract, statute or notice in the workspace.