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Billing code V5120 · Vision & hearing

V5120 Medicaid reimbursement rate by state (2026)

Binaural, body. Medicaid pays a median of $659.30 for V5120 across 16 states, from $1.53 in California to $1,107.46 in Louisiana.

Data as of Oct 5, 202616 statesEvery rate links to its official source

States publishing
16
National median
$659.30units vary by state
Lowest
$1.53California
Highest
$1,107.46Louisiana
Answer

What does Medicaid pay for V5120?

16 state Medicaid programs publish a fee-for-service rate for V5120. The national median is $659.30 (units differ between states). Louisiana pays the most, $1,107.46, and California the least, $1.53, a 723.8x spread.

State ranking

V5120 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 16 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Louisiana Source · since 2014-07-01$1,107.46——Plans must pay at least this—
2Montana Source · since 2025-07-01$1,060.45——Not classified—
3Idaho Source · since 2025-09-01$923.90——Not classified—
8Nevada Source · since 2024-01-01$700.00——Paid by the state, outside plans—
9New Hampshire Source · since 2020-01-01$618.60——Plans negotiate; applies out of network—
10Connecticut Source · since 2007-05-01$600.00——Not classified—
15Wisconsin Source · since 2022-01-01$32.53——Plans negotiate; applies out of network—
16California Source · since 2026-10-01$1.53——Plans negotiate; applies out of network—
See all 16 states for V5120 — start free

8 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 V5120 in your states. Get an alert when any state changes it, with every variant and the managed-care rule.
FAQ

Frequently asked questions

What does Medicaid pay for V5120?

It depends on the state. Of the 16 states with a published fee-for-service rate, the median is $659.30. Louisiana pays the most ($1,107.46) and California the least ($1.53).

Which state pays the highest Medicaid rate for V5120?

Louisiana, at $1,107.46, effective 2014-07-01.

Do managed-care plans pay the same rate for V5120?

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 workspace shows the rule for each state, cited to the contract or statute.