V5362 Medicaid reimbursement rate by state (2026)

• Order. States are listed from the highest published rate to the lowest. No single unit is shared by 8 or more states for V5362, 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. 2 of the 6 states list more than one rate for V5362, 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 6 schedules prints a separate unit for V5362, so each amount is a flat payment for one service as the code defines it.
• Per hour. V5362 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 V5362, 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.

Published rates for V5362 run from $15.42 in Iowa to $40.00 in Alaska, a 2.6x gap in the same unit. Half the states pay more than the median of $24.62 and half pay less. The usual reasons for a spread like this in therapy (PT/OT/speech) rates:

• Children's therapy is driven by the EPSDT benefit, so some states maintain separate pediatric rates or programs.
• Visit limits, prior authorization and annual caps vary by state and change how much a single code is worth to a practice.
• States pay therapy by CPT code, but many pay therapy assistants a reduced percentage and some pay differently in outpatient hospital, private practice and home settings.

Timing matters too. None of the states changed its rate for V5362 in 2026, while 1 state 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.

No managed-care plan publishes what it pays for V5362. What is public is the rule each state's plan contracts set, and that rule decides how much the published rate matters when you contract with a plan.

In 2 states, plans negotiate and the published rate is a benchmark or out-of-network default. In 1 state, the service is paid outside the plans or through a state-directed payment. The rule for the remaining 3 states is not classified yet.

• 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.
• Paid by the state, outside the plans (1 state). Bill the state's Medicaid program, not the plan, at the published rate. There is no plan contract to negotiate for this service.

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 Alaska managed care.

V5362 is a HCPCS Level II vision, hearing and speech code in the therapy (PT/OT/speech) line, billed mostly by physical, occupational and speech therapists and therapy practices. V codes cover lenses, frames, prosthetic eyes, hearing aids and related services, generally paid per item and per side.

Many treatment codes are timed in 15-minute units, while evaluations and re-evaluations are billed once per session. Medicare applies a rule for counting timed minutes into units; Medicaid programs may follow it or set their own, so check the state's therapy manual.

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.