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