V2628 Medicaid reimbursement rates by state
Fabrication and fitting of ocular conformer. 25 state Medicaid programs publish a fee-for-service rate for V2628 at the physician psychologist level. Rates run from $123.57 in Illinois to $447.25 in Nebraska, with a median of $285.81.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 25
- Median rate
- $285.81units vary by state
- Highest
- $447.25Nebraska
- Medicare (non-facility)
- —not on the physician fee schedule
V2628 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 |
|---|---|---|---|---|---|---|
| NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service) | $447.25since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Nebraska Medicaid fee schedule 471-000-5 |
| ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP) | $405.59since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Child Health Plan Plus FY 2026-2027 Fee |
| OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA) | $380.38since 2024-10-01 | — | — | Plans negotiate; applies out of network | — | OHP FFS medical-dental fee schedule (fee |
| WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service | $373.26since 2021-01-01 | — | — | 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) | $365.17since 2026-01-01 | unit | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service) | $362.39since 2022-07-01 | — | — | Plans must pay at least this | — | MO HealthNet fee schedule: Optometrist a |
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $361.00since 2009-01-01 | — | — | Plans negotiate; applies out of network | — | ForwardHealth max fee schedule: Vision ( |
| South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service) | $323.89since 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) | $316.61since 2026-01-01 | — | — | Not classified | — | Maryland Medicaid DME/DMS/Oxygen, Prosth |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $312.24since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | AHCCCS FFS Capped Fee Schedule: Durable |
| IowaAny qualified provider (rate does not vary by provider) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $297.14since 2013-07-01 | — | — | Plans must pay at least this | — | Iowa Medicaid fee schedule #07 OPTICIAN |
| New YorkPhysician or licensed psychologist (incl. BCBA-D) · New York Medicaid (fee-for-service) | $296.73since 2026-01-01 | unit | — | Plans negotiate; applies out of network | — | eMedNY Physician Fee Schedule Sect 2 (Me |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $285.81since 2014-01-01 | — | — | Plans negotiate; applies out of network | — | MHCP Fee Schedule - Current Fee Schedule |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $275.64since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | MDHHS Medical Suppliers/Orthotists/Prost |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $264.83since 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) | $260.25 | — | — | Plans negotiate; applies out of network | — | NC Medicaid fee schedule 'Orthotics and |
| 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 |
| ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP) | $254.49since 2007-05-01 | — | — | Not classified | — | CMAP fee schedule: 7/1/2025 MEDS - Heari |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $250.49since 2020-01-01 | — | — | State sets the plan rate | — | KY Medicaid DME fee schedule (2020Medica |
| LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service) | $250.38since 2012-07-01 | — | — | Plans must pay at least this | — | Louisiana Medicaid Durable Medical Equip |
| TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP) | $230.61since 2026-09-01 | — | — | Plans negotiate; applies out of network | — | TMHP Texas Medicaid Fee Schedule - Physi |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $221.27since 2024-01-01 | — | — | Plans negotiate; applies out of network | — | Appendix DD to OAC 5160-1-60 (Non-Instit |
| GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service) | $219.13since 2016-07-01 | — | — | Plans negotiate; applies out of network | — | Orthotic and Prosthetic Fee Schedule - E |
| FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service) | $210.94since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | Visual Services Fee Schedule (AHCA Updat |
| IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service) | $123.57since 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 V2628?
It depends on the state. Of the 25 states with a published fee-for-service rate, the median is $285.81. Nebraska pays the most ($447.25) and Illinois the least ($123.57).
Which state pays the highest Medicaid rate for V2628?
Nebraska, at $447.25, effective 2026-07-01.
Do managed-care plans pay the same rate for V2628?
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 V2628 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.