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Billing code V2202 · Vision & hearing

V2202 Medicaid reimbursement rate by state (2026)

Sphere, bifocal, plus or minus 7.12 to plus or minus 20.00d. Medicaid pays a median of $45.88 for V2202 across 36 states, from $5.00 in Vermont to $107.33 in Delaware.

Data as of Oct 5, 202636 statesEvery rate links to its official source

States publishing
36
National median
$45.88units vary by state
Lowest
$5.00Vermont
Highest
$107.33Delaware
Answer

What does Medicaid pay for V2202?

36 state Medicaid programs publish a fee-for-service rate for V2202. The national median is $45.88 (units differ between states). Delaware pays the most, $107.33, and Vermont the least, $5.00, a 21.5x spread.

State ranking

V2202 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 36 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Delaware Source · since 2026-01-01$107.33——Plans negotiate; applies out of network—
2District of Columbia Source · since 2026-04-01$85.86——Not classified—
3West Virginia Source · since 2026-04-01$85.14——Plans negotiate; applies out of network—
18Nebraska Source · since 2026-07-01$46.26——Plans negotiate; applies out of network—
19Virginia Source · since 2022-07-01$45.50——Plans negotiate; applies out of network—
20Texas Source · since 2026-09-01$43.37——Plans negotiate; applies out of network—
35Wisconsin Source · since 2025-09-01$6.30——Plans negotiate; applies out of network—
36Vermont Source · since 2023-03-01$5.00——Not classified—
See all 36 states for V2202 — start free

28 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.

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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 V2202 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 V2202, 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. 17 of the 36 states list more than one rate for V2202, 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. Of the 36 states, 1 publish V2202 per unit, and 35 schedules print no unit at all (a flat amount per service).
  • Per hour. V2202 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 V2202, 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 V2202 rates differ between states

Published rates for V2202 run from $5.00 in Vermont to $107.33 in Delaware, a 21.5x gap in the same unit. Half the states pay more than the median of $45.88 and half pay less. The usual reasons for a spread like this in vision & hearing rates:

  • 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.
  • Some states buy eyeglasses through a single contracted laboratory, which changes what a provider is paid for the materials.

Timing matters too. 17 states set the current rate for V2202 in 2026 or later, while 11 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 V2202

No managed-care plan publishes what it pays for V2202. 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 8 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 21 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 7 states is not classified yet.

  • Plans negotiate; the published rate applies out of network (21 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.
  • Plans must pay at least the published rate (8 states). The published rate is your floor. Negotiate up from it, and if a plan pays less, the contract provision is the basis for a payment dispute.

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 Delaware managed care.

Billing

Units and billing for V2202

V2202 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 V2202?

It depends on the state. Of the 36 states with a published fee-for-service rate, the median is $45.88. Delaware pays the most ($107.33) and Vermont the least ($5.00).

Which state pays the highest Medicaid rate for V2202?

Delaware, at $107.33, effective 2026-01-01.

Which state pays the lowest Medicaid rate for V2202?

Vermont, at $5.00, effective 2023-03-01.

What unit is V2202 billed in?

Of the 36 states, 1 publish V2202 per unit, and 35 schedules print no unit at all (a flat amount per service).

Do managed-care plans pay the same rate for V2202?

Not necessarily. In 8 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 21 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 7 states is not classified yet. Each rule is cited to the plan contract, statute or notice in the workspace.