V5243 Medicaid reimbursement rate by state (2026)
Hearing aid, analog, monaural, itc (in the canal). Medicaid pays a median of $425.18 for V5243 across 11 states, from $32.53 in Wisconsin to $550.00 in Virginia.
- States publishing
- 11
- National median
- $425.18units vary by state
- Lowest
- $32.53Wisconsin
- Highest
- $550.00Virginia
What does Medicaid pay for V5243?
11 state Medicaid programs publish a fee-for-service rate for V5243. The national median is $425.18 (units differ between states). Virginia pays the most, $550.00, and Wisconsin the least, $32.53, a 16.9x spread.
V5243 rate by state: highest, middle and lowest
One like-for-like fee-for-service rate per state, ranked. The workspace lists all 11 states with every variant, modifier and effective date.
Frequently asked questions
What does Medicaid pay for V5243?
It depends on the state. Of the 11 states with a published fee-for-service rate, the median is $425.18. Virginia pays the most ($550.00) and Wisconsin the least ($32.53).
Which state pays the highest Medicaid rate for V5243?
Virginia, at $550.00, effective 2008-01-01.
Do managed-care plans pay the same rate for V5243?
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.