V2104 Medicaid reimbursement rates by state
Spherocylinder, single vision. 22 state Medicaid programs publish a fee-for-service rate for V2104 at the physician psychologist level. Rates run from $6.06 in New York to $48.42 in Indiana, with a median of $18.17.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 22
- Median rate
- $18.17units vary by state
- Highest
- $48.42Indiana
- Medicare (non-facility)
- —not on the physician fee schedule
V2104 rate in every state
One like-for-like fee-for-service rate per state, highest first. Units can differ between states; the per-hour column converts time-based units.
| State | Medicaid rate | Unit | Per hour | Managed-care plans | % of Medicare | Source |
|---|---|---|---|---|---|---|
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $48.42since 2026-01-01 | unit | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $45.50since 2022-07-01 | — | — | Plans negotiate; applies out of network | — | DMAS procedure fee file hcpcmedical.csv |
| ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP) | $43.85since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Child Health Plan Plus FY 2026-2027 Fee |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $43.04since 2026-07-01 | — | — | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $42.04since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | ODM DMEPOS combined payment schedules (a |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $40.61since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | AHCCCS FFS Capped Fee Schedule: Durable |
| MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service) | $33.65since 2022-07-01 | — | — | Plans must pay at least this | — | MO HealthNet fee schedule: Optometrist a |
| MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $32.05since 2025-02-14 | — | — | Plans negotiate; applies out of network | — | Rates for Vision Care Services and Ophth |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $28.00since 2022-01-01 | — | — | Plans negotiate; applies out of network | — | KY Medicaid Vision fee schedule (2022Vis |
| TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP) | $26.35since 2026-09-01 | — | — | Plans negotiate; applies out of network | — | TMHP Texas Medicaid Fee Schedule - Physi |
| CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service) | $18.62since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | Medi-Cal Rates (Rates files zip: rates_d |
| NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service) | $17.71since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Nebraska Medicaid fee schedule 471-000-5 |
| ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP) | $17.55since 2008-07-01 | — | — | Not classified | — | CMAP fee schedule: Optician/Eyeglasses A |
| OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA) | $14.47since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | OHP FFS medical-dental fee schedule (fee |
| IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $12.76since 2013-07-01 | — | — | Plans must pay at least this | — | Iowa Medicaid fee schedule #02 PHYSICIAN |
| LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service) | $11.10since 2024-09-01 | — | — | Plans must pay at least this | — | Louisiana Medicaid Vision (Eyewear) Fee |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $10.67since 2023-01-01 | — | — | Plans negotiate; applies out of network | — | MDHHS Vision Fee Schedule database, 2023 |
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $10.49since 2025-09-01 | — | — | Plans negotiate; applies out of network | — | ForwardHealth max fee schedule: State Pu |
| FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service) | $7.59since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | Visual Services Fee Schedule (AHCA Updat |
| South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service) | $6.30since 2020-07-01 | — | — | Not classified | — | SCDHHS Pediatric Subspecialty and Neonat |
| IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service) | $6.22since 2019-12-03 | — | — | Plans negotiate; applies out of network | — | HFS Optical Supplies Fee Schedule (effec |
| New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service) | $6.06since 2023-01-01 | — | — | Plans negotiate; applies out of network | — | eMedNY NYS Medicaid Vision Care Fee Sche |
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 with the CMS formula; states with several Medicare localities show a range. Confirm rates with the payer before billing.
Frequently asked questions
What does Medicaid pay for V2104?
It depends on the state. Of the 22 states with a published fee-for-service rate, the median is $18.17. Indiana pays the most ($48.42 per unit) and New York the least ($6.06).
Which state pays the highest Medicaid rate for V2104?
Indiana, at $48.42 per unit, effective 2026-01-01.
Do managed-care plans pay the same rate for V2104?
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 table shows the rule for each state, cited to the contract or statute.
Related Vision & hearing codes
92060Eye exams and vision services · 29 states92083Eye exams and vision services · 29 states92235Eye exams and vision services · 29 states92652Hearing tests and audiology services · 29 states92025Eye exams and vision services · 28 states92240Eye exams and vision services · 28 states92242Eye exams and vision services · 28 states92265Eye exams and vision services · 28 states92565Hearing tests and audiology services · 27 states92572Hearing tests and audiology services · 26 states92609Therapy using a communication device · 26 statesV2624Polishing/resurfacing of ocular prosthesis · 26 states
Track V2104 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.