V2625 Medicaid reimbursement rates by state
Enlargement of ocular prosthesis. 35 state Medicaid programs publish a fee-for-service rate for V2625 at the physician psychologist level. Rates run from $188.69 in Illinois to $585.75 in Montana, with a median of $366.54.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 35
- Median rate
- $366.54units vary by state
- Highest
- $585.75Montana
- Medicare (non-facility)
- —not on the physician fee schedule
V2625 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 |
|---|---|---|---|---|---|---|
| MontanaAny qualified provider (rate does not vary by provider) · Montana Medicaid and HMK Plus (fee-for-service) | $585.75since 2025-01-01 | — | — | Not classified | — | Montana Healthcare Programs fee schedule |
| WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service | $583.01since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | HCA Physician-related services fee sched |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $578.67since 2026-01-01 | unit | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service) | $543.85since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Nebraska Medicaid fee schedule 471-000-5 |
| New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division) | $525.86since 2023-07-01 | — | — | Plans must pay at least this | — | New Mexico Medicaid Fee for Service HCPC |
| IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell) | $521.99since 2026-07-01 | — | — | Not classified | — | Idaho Medicaid Numerical Fee Schedule Ju |
| ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP) | $487.93since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Child Health Plan Plus FY 2026-2027 Fee |
| KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule | $483.33since 2026-07-01 | — | — | Not classified | — | KMAP Fee Schedule QMB Medicaid (FeeSched |
| OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA) | $462.74since 2024-10-01 | — | — | Plans negotiate; applies out of network | — | OHP FFS medical-dental fee schedule (fee |
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $461.08since 2018-01-01 | — | — | Plans negotiate; applies out of network | — | ForwardHealth max fee schedule: Durable |
| MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service) | $453.12since 2026-01-01 | — | — | Not classified | — | MaineCare Section 60, Medical Supplies a |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $452.92since 2014-01-01 | — | — | Plans negotiate; applies out of network | — | MHCP Fee Schedule - Current Fee Schedule |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $442.94since 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) | $440.85since 2022-07-01 | — | — | Plans must pay at least this | — | MO HealthNet fee schedule: Optometrist a |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $436.78since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | MDHHS Medical Suppliers/Orthotists/Prost |
| South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service) | $390.02since 2024-07-01 | — | — | Not classified | — | SCDHHS Durable Medical Equipment (DME) F |
| MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH) | $385.15since 2026-01-01 | — | — | Not classified | — | Maryland Medicaid DME/DMS/Oxygen, Prosth |
| IowaAny qualified provider (rate does not vary by provider) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $366.54since 2013-07-01 | — | — | Plans must pay at least this | — | Iowa Medicaid fee schedule #07 OPTICIAN |
| West VirginiaAny qualified provider (rate does not vary by provider) · West Virginia Medicaid (fee-for-service, Bureau for Medical Services) | $359.41since 2026-04-01 | — | — | Plans negotiate; applies out of network | — | BMS Vision Fee Schedule |
| MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service) | $351.02since 2020-07-01 | — | — | Plans must pay at least this | — | DOM Comprehensive Fee Schedule, Septembe |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $350.62since 2024-01-01 | — | — | Plans negotiate; applies out of network | — | Appendix DD to OAC 5160-1-60 (Non-Instit |
| NevadaAny qualified provider (rate does not vary by provider) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules) | $346.16since 2024-04-01 | — | — | Plans must pay at least this | — | Provider Type 41, Optician, Optical Busi |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $317.18since 2026-07-01 | — | — | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
| North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service) | $313.37 | — | — | Plans negotiate; applies out of network | — | NC Medicaid fee schedule 'Orthotics and |
| ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP) | $309.59since 2007-05-01 | — | — | Not classified | — | CMAP fee schedule: 7/1/2025 MEDS - Heari |
| ArkansasPhysician or licensed psychologist (incl. BCBA-D) · Arkansas Medicaid (fee-for-service) | $307.63since 2025-06-13 | — | — | Not classified | — | Arkansas Medicaid Physician / CRNA / Fam |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $301.62since 2020-01-01 | — | — | State sets the plan rate | — | KY Medicaid DME fee schedule (2020Medica |
| GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service) | $263.86since 2016-07-01 | — | — | Plans negotiate; applies out of network | — | Orthotic and Prosthetic Fee Schedule - E |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $260.00since 2022-07-01 | — | — | Plans negotiate; applies out of network | — | DMAS procedure fee file hcpcmedical.csv |
| OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA) | $256.96since 2020-08-01 | — | — | Plans must pay at least this | — | SoonerCare Durable Medical Equipment Rat |
| LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service) | $254.93since 2012-07-01 | — | — | Plans must pay at least this | — | Louisiana Medicaid Durable Medical Equip |
| FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service) | $245.28since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | Visual Services Fee Schedule (AHCA Updat |
| TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP) | $234.81since 2026-09-01 | — | — | Plans negotiate; applies out of network | — | TMHP Texas Medicaid Fee Schedule - Physi |
| New YorkPhysician or licensed psychologist (incl. BCBA-D) · New York Medicaid (fee-for-service) | $202.00since 2023-01-01 | unit | — | Plans negotiate; applies out of network | — | eMedNY Physician Fee Schedule Sect 2 (Me |
| IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service) | $188.69since 2025-01-01 | — | — | Plans negotiate; applies out of network | — | HFS Optometric Fee Schedule (effective 2 |
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 V2625?
It depends on the state. Of the 35 states with a published fee-for-service rate, the median is $366.54. Montana pays the most ($585.75) and Illinois the least ($188.69).
Which state pays the highest Medicaid rate for V2625?
Montana, at $585.75, effective 2025-01-01.
Do managed-care plans pay the same rate for V2625?
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 · 39 states92083Eye exams and vision services · 39 states92025Eye exams and vision services · 38 states92265Eye exams and vision services · 38 statesV2624Polishing/resurfacing of ocular prosthesis · 36 states92609Therapy using a communication device · 34 statesV2626Reduction of ocular prosthesis · 34 statesV2628Fabrication and fitting of ocular conformer · 34 statesV2627Scleral cover shell · 33 statesV5264Ear mold/insert, not disposable, any type · 32 statesV5266Battery for use in hearing device · 32 statesV2020Frames, purchases · 29 states
Track V2625 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.