V5250 Medicaid reimbursement rates by state
Hearing aid, digitally programmable analog, binaural, cic. 6 state Medicaid programs publish a fee-for-service rate for V5250. Rates run from $32.53 in Wisconsin to $1,131.53 in Colorado, with a median of $826.00.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 6
- Median rate
- $826.00units vary by state
- Highest
- $1,131.53Colorado
- Medicare (non-facility)
- —not on the physician fee schedule
V5250 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 |
|---|---|---|---|---|---|---|
| ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service) | $1,131.53since 2026-07-01 | — | — | Not classified | — | Health First Colorado Physician Fee Sche |
| NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service) | $1,129.79since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Nebraska Medicaid fee schedule 471-000-5 |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $900.00since 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) | $752.00since 2019-07-24 | — | — | Plans negotiate; applies out of network | — | HFS DME Fee Schedule (effective 2019-07- |
| MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service) | $396.64since 2019-07-01 | — | — | Plans negotiate; applies out of network | — | MO HealthNet fee schedule: Hearing Aid |
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $32.53since 2022-01-01 | — | — | Plans negotiate; applies out of network | — | ForwardHealth max fee schedule: Hearing |
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 V5250?
It depends on the state. Of the 6 states with a published fee-for-service rate, the median is $826.00. Colorado pays the most ($1,131.53) and Wisconsin the least ($32.53).
Which state pays the highest Medicaid rate for V5250?
Colorado, at $1,131.53, effective 2026-07-01.
Do managed-care plans pay the same rate for V5250?
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.