Skip to content
Billing code V2599 · Vision & hearing

V2599 Medicaid reimbursement rate by state (2026)

Contact lens, other type. Medicaid pays a median of $58.29 for V2599 across 6 states, from $27.61 in South Dakota to $400.00 in District of Columbia.

Data as of Oct 5, 20266 statesEvery rate links to its official source

States publishing
6
National median
$58.29units vary by state
Lowest
$27.61South Dakota
Highest
$400.00District of Columbia
Answer

What does Medicaid pay for V2599?

6 state Medicaid programs publish a fee-for-service rate for V2599. The national median is $58.29 (units differ between states). District of Columbia pays the most, $400.00, and South Dakota the least, $27.61, a 14.5x spread.

State ranking

V2599 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 6 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1District of Columbia Source · since 1983-10-01$400.00——Not classified—
2Maine Source · since 2023-01-01$300.00——Not classified—
3Hawaii Source · since 2024-03-04$59.80——Plans negotiate; applies out of network—
6South Dakota Source · since 2026-07-01$27.61——Not classified—
See all 6 states for V2599 — start free

2 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.

  • Source for every rate
  • Full rate history
  • CSV and API export

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 V2599 in your states. Get an alert when any state changes it, with every variant and the managed-care rule.
Guide

How to read this table

  • Order. States are listed from the highest published rate to the lowest. No single unit is shared by 8 or more states for V2599, 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 V2599, 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 V2599, so each amount is a flat payment for one service as the code defines it.
  • Per hour. V2599 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 V2599, 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.
Context

Why V2599 rates differ between states

Published rates for V2599 run from $27.61 in South Dakota to $400.00 in District of Columbia, a 14.5x gap in the same unit. Half the states pay more than the median of $58.29 and half pay less. The usual reasons for a spread like this in vision & hearing rates:

  • Adult vision and hearing benefits are optional for states, so coverage, limits and fees vary widely.
  • Some states buy eyeglasses through a single contracted laboratory, which changes what a provider is paid for the materials.
  • Hearing aids and some lenses are priced at invoice or acquisition cost in some states and at a fixed fee in others.

Timing matters too. 2 states set the current rate for V2599 in 2026 or later, 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.

Managed care

What managed-care plans pay for V2599

No managed-care plan publishes what it pays for V2599. 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. The rule for the remaining 4 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.

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 District of Columbia managed care.

Billing

Units and billing for V2599

V2599 is a HCPCS Level II vision, hearing and speech code in the vision & hearing line, billed mostly by optometrists, opticians, audiologists and hearing aid dispensers. V codes cover lenses, frames, prosthetic eyes, hearing aids and related services, generally paid per item and per side.

Vision and hearing materials are billed per item, per lens or per device, and hearing aids per ear (monaural or binaural).

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.

FAQ

Frequently asked questions

What does Medicaid pay for V2599?

It depends on the state. Of the 6 states with a published fee-for-service rate, the median is $58.29. District of Columbia pays the most ($400.00) and South Dakota the least ($27.61).

Which state pays the highest Medicaid rate for V2599?

District of Columbia, at $400.00, effective 1983-10-01.

Which state pays the lowest Medicaid rate for V2599?

South Dakota, at $27.61, effective 2026-07-01.

What unit is V2599 billed in?

None of the 6 schedules prints a separate unit for V2599, so each amount is a flat payment for one service as the code defines it.

Do managed-care plans pay the same rate for V2599?

Not necessarily. In 2 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 4 states is not classified yet. Each rule is cited to the plan contract, statute or notice in the workspace.