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Billing code V2311 · Vision & hearing

V2311 Medicaid reimbursement rate by state (2026)

Spherocylinder, trifocal. Medicaid pays a median of $72.00 for V2311 across 30 states, from $6.30 in Wisconsin to $149.74 in Hawaii.

Data as of Oct 5, 202630 statesEvery rate links to its official source

States publishing
30
National median
$72.00units vary by state
Lowest
$6.30Wisconsin
Highest
$149.74Hawaii
Answer

What does Medicaid pay for V2311?

30 state Medicaid programs publish a fee-for-service rate for V2311. The national median is $72.00 (units differ between states). Hawaii pays the most, $149.74, and Wisconsin the least, $6.30, a 23.8x spread.

State ranking

V2311 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 30 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Hawaii Source · since 2026-06-01$149.74——Plans negotiate; applies out of network—
2Indiana Source · since 2026-01-01$126.13unit—Plans must pay at least this—
3Delaware Source · since 2026-01-01$122.68——Plans negotiate; applies out of network—
15New Jersey Source · since 2026-07-01$76.64——Not classified—
16Wyoming Source · since 2021-01-01$67.36——Not classified—
17Texas Source · since 2026-09-01$65.54——Plans negotiate; applies out of network—
29Vermont Source · since 2023-03-01$10.00——Not classified—
30Wisconsin Source · since 2025-09-01$6.30——Plans negotiate; applies out of network—
See all 30 states for V2311 — start free

22 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
  • CSV and API export

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 V2311 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 V2311, 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. 12 of the 30 states list more than one rate for V2311, 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 30 states, 1 publish V2311 per unit, and 29 schedules print no unit at all (a flat amount per service).
  • Per hour. V2311 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 V2311, 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 V2311 rates differ between states

Published rates for V2311 run from $6.30 in Wisconsin to $149.74 in Hawaii, a 23.8x gap in the same unit. Half the states pay more than the median of $72.00 and half pay less. The usual reasons for a spread like this in vision & hearing rates:

  • 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.
  • Hearing aids and some lenses are priced at invoice or acquisition cost in some states and at a fixed fee in others.

Timing matters too. 16 states set the current rate for V2311 in 2026 or later, while 7 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 V2311

Most Medicaid members are in managed-care plans, and plans don't publish their provider fee schedules. For V2311, the public signal is the rule each state sets for its plans, recorded on each rate above.

In 7 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 18 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 5 states is not classified yet.

  • Plans negotiate; the published rate applies out of network (18 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 (7 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 Hawaii managed care.

Billing

Units and billing for V2311

V2311 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 V2311?

It depends on the state. Of the 30 states with a published fee-for-service rate, the median is $72.00. Hawaii pays the most ($149.74) and Wisconsin the least ($6.30).

Which state pays the highest Medicaid rate for V2311?

Hawaii, at $149.74, effective 2026-06-01.

Which state pays the lowest Medicaid rate for V2311?

Wisconsin, at $6.30, effective 2025-09-01.

What unit is V2311 billed in?

Of the 30 states, 1 publish V2311 per unit, and 29 schedules print no unit at all (a flat amount per service).

Do managed-care plans pay the same rate for V2311?

Not necessarily. In 7 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 18 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 5 states is not classified yet. Each rule is cited to the plan contract, statute or notice in the workspace.