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Billing code V5259 · Vision & hearing

V5259 Medicaid reimbursement rate by state (2026)

Hearing aid, digital, binaural, itc. Medicaid pays a median of $1,095.12 for V5259 across 24 states, from $32.53 in Wisconsin to $3,200.00 in Mississippi.

Data as of Oct 5, 202624 statesEvery rate links to its official source

States publishing
24
National median
$1,095.12units vary by state
Lowest
$32.53Wisconsin
Highest
$3,200.00Mississippi
Answer

What does Medicaid pay for V5259?

24 state Medicaid programs publish a fee-for-service rate for V5259. The national median is $1,095.12 (units differ between states). Mississippi pays the most, $3,200.00, and Wisconsin the least, $32.53, a 98.4x spread.

State ranking

V5259 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 24 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Mississippi Source · since 2013-12-01$3,200.00——Plans must pay at least this—
2District of Columbia Source · since 2008-03-01$3,000.00——Not classified—
3Georgia Source · since 2020-04-01$2,651.00——Plans negotiate; applies out of network—
12Nebraska Source · since 2026-07-01$1,129.79——Plans negotiate; applies out of network—
13Montana Source · since 2025-07-01$1,060.45——Not classified—
14Idaho Source · since 2025-09-01$1,053.73——Not classified—
23Kansas Source · since 2006-03-01$65.00——Plans must pay at least this—
24Wisconsin Source · since 2022-01-01$32.53——Plans negotiate; applies out of network—
See all 24 states for V5259 — start free

16 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 V5259 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 V5259?

It depends on the state. Of the 24 states with a published fee-for-service rate, the median is $1,095.12. Mississippi pays the most ($3,200.00) and Wisconsin the least ($32.53).

Which state pays the highest Medicaid rate for V5259?

Mississippi, at $3,200.00, effective 2013-12-01.

Do managed-care plans pay the same rate for V5259?

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.