V5241 Medicaid reimbursement rates by state
Dispensing fee, monaural hearing aid, any type. 24 state Medicaid programs publish a fee-for-service rate for V5241 at the physician psychologist level. Rates run from $62.40 in Nebraska to $358.93 in Wisconsin, with a median of $197.00.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 24
- Median rate
- $197.00units vary by state
- Highest
- $358.93Wisconsin
- Medicare (non-facility)
- —not on the physician fee schedule
V5241 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 |
|---|---|---|---|---|---|---|
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $358.93since 2022-01-01 | — | — | Plans negotiate; applies out of network | — | ForwardHealth max fee schedule: Hearing |
| MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $331.26since 2025-12-01 | — | — | Plans negotiate; applies out of network | — | Rates for Hearing Services (effective De |
| New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division) | $318.00since 2025-01-01 | — | — | Plans must pay at least this | — | New Mexico Medicaid Fee for Service HCPC |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $300.00since 2008-01-01 | — | — | 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) | $300.00since 2008-02-01 | — | — | Not classified | — | CMAP fee schedule: 7/1/2025 MEDS - Heari |
| MontanaAny qualified provider (rate does not vary by provider) · Montana Medicaid and HMK Plus (fee-for-service) | $287.03since 2025-07-01 | — | — | Not classified | — | Montana Healthcare Programs fee schedule |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $275.00since 2023-09-01 | — | — | Plans negotiate; applies out of network | — | MDHHS Hearing Aid Dealers Fee Schedule d |
| IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service) | $264.10since 2024-01-01 | — | — | Plans negotiate; applies out of network | — | HFS DME Fee Schedule (effective 2024-01- |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $261.55since 2026-01-01 | unit | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| NevadaAny qualified provider (rate does not vary by provider) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules) | $234.09since 2024-04-01 | — | — | Plans must pay at least this | — | Provider Type 23 Hearing Aid Dispenser & |
| IowaAny qualified provider (rate does not vary by provider) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $228.88since 2013-07-01 | — | — | Plans must pay at least this | — | Iowa Medicaid fee schedule #17 AUDIOLOGI |
| KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule) | $200.00since 2002-01-01 | — | — | Paid by the state, outside plans | — | KMAP Fee Schedule MKN Medicaid (FeeSched |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $194.00since 2010-01-01 | Each | — | Plans negotiate; applies out of network | — | ODM DMEPOS payment schedule (appendix to |
| TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP) | $192.00since 2021-09-01 | — | — | Plans negotiate; applies out of network | — | TMHP Texas Medicaid Fee Schedule - Physi |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $182.15since 2002-01-01 | — | — | Plans negotiate; applies out of network | — | MHCP Fee Schedule - Current Fee Schedule |
| PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service) | $150.00since 2007-08-01 | — | — | Plans negotiate; applies out of network | — | PA DHS PROMISe Outpatient Fee Schedule ( |
| New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service) | $136.35since 2022-04-01 | — | — | Plans negotiate; applies out of network | — | eMedNY NYS Medicaid Hearing Aid / Audiol |
| MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service) | $128.52since 2026-01-01 | — | — | Not classified | — | MaineCare Fee Schedule (MaineCare UCR, H |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $125.94since 2023-01-01 | — | — | Plans negotiate; applies out of network | — | KY Medicaid Audiology fee schedule (2023 |
| MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service) | $97.88since 2019-07-01 | — | — | Plans negotiate; applies out of network | — | MO HealthNet fee schedule: Hearing Aid |
| MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service) | $88.70since 2013-12-01 | — | — | Plans must pay at least this | — | DOM Comprehensive Fee Schedule, Septembe |
| North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service) | $84.88since 2025-10-01 | — | — | Plans negotiate; applies out of network | — | NC Medicaid fee schedule 'Hearing Aid Pr |
| OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA) | $73.04since 2024-10-01 | — | — | Plans negotiate; applies out of network | — | OHP FFS medical-dental fee schedule (fee |
| NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service) | $62.40since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Nebraska Medicaid fee schedule 471-000-5 |
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 V5241?
It depends on the state. Of the 24 states with a published fee-for-service rate, the median is $197.00. Wisconsin pays the most ($358.93) and Nebraska the least ($62.40).
Which state pays the highest Medicaid rate for V5241?
Wisconsin, at $358.93, effective 2022-01-01.
Do managed-care plans pay the same rate for V5241?
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 statesV2625Enlargement of ocular prosthesis · 35 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 states
Track V5241 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.