V2799 Medicaid reimbursement rate by state (2026)
Vision item or service, miscellaneous. Medicaid pays a median of $31.38 for V2799 across 10 states, from $1.56 in Hawaii to $100.00 in Vermont.
- States publishing
- 10
- National median
- $31.38units vary by state
- Lowest
- $1.56Hawaii
- Highest
- $100.00Vermont
What does Medicaid pay for V2799?
10 state Medicaid programs publish a fee-for-service rate for V2799. The national median is $31.38 (units differ between states). Vermont pays the most, $100.00, and Hawaii the least, $1.56, a 64.1x spread.
V2799 rate by state: highest, middle and lowest
One like-for-like fee-for-service rate per state, ranked. The workspace lists all 10 states with every variant, modifier and effective date.
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 V2799, 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. 4 of the 10 states list more than one rate for V2799, 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 10 schedules prints a separate unit for V2799, so each amount is a flat payment for one service as the code defines it.
- Per hour. V2799 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 V2799, 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.
Why V2799 rates differ between states
Published rates for V2799 run from $1.56 in Hawaii to $100.00 in Vermont, a 64.1x gap in the same unit. Half the states pay more than the median of $31.38 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. 1 state set the current rate for V2799 in 2026 or later, while 4 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.
What managed-care plans pay for V2799
Most Medicaid members are in managed-care plans, and plans don't publish their provider fee schedules. For V2799, the public signal is the rule each state sets for its plans, recorded on each rate above.
In 2 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 2 states, plans negotiate and the published rate is a benchmark or out-of-network default. In 2 states, the service is paid outside the plans or through a state-directed payment. The rule for the remaining 4 states is not classified yet.
- Plans must pay at least the published rate (2 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.
- Paid by the state, outside the plans (2 states). Bill the state's Medicaid program, not the plan, at the published rate. There is no plan contract to negotiate for this service.
- Plans negotiate; the published rate applies out of network (2 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 Vermont managed care.
Units and billing for V2799
V2799 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.
Frequently asked questions
What does Medicaid pay for V2799?
It depends on the state. Of the 10 states with a published fee-for-service rate, the median is $31.38. Vermont pays the most ($100.00) and Hawaii the least ($1.56).
Which state pays the highest Medicaid rate for V2799?
Vermont, at $100.00, effective 2023-03-01.
Which state pays the lowest Medicaid rate for V2799?
Hawaii, at $1.56, effective 2024-03-04.
What unit is V2799 billed in?
None of the 10 schedules prints a separate unit for V2799, so each amount is a flat payment for one service as the code defines it.
Do managed-care plans pay the same rate for V2799?
Not necessarily. In 2 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 2 states, plans negotiate and the published rate is a benchmark or out-of-network default. In 2 states, the service is paid outside the plans or through a state-directed payment. The rule for the remaining 4 states is not classified yet. Each rule is cited to the plan contract, statute or notice in the workspace.