V5252 Medicaid reimbursement rates by state
Hearing aid, digitally programmable, binaural, ite. 12 state Medicaid programs publish a fee-for-service rate for V5252. Rates run from $32.53 in Wisconsin to $1,467.40 in Oregon, with a median of $726.00.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 12
- Median rate
- $726.00units vary by state
- Highest
- $1,467.40Oregon
- Medicare (non-facility)
- —not on the physician fee schedule
V5252 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 |
|---|---|---|---|---|---|---|
| OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA) | $1,467.40since 2024-10-01 | — | — | Plans negotiate; applies out of network | — | OHP FFS medical-dental fee schedule (fee |
| 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 |
| MontanaAny qualified provider (rate does not vary by provider) · Montana Medicaid and HMK Plus (fee-for-service) | $1,060.45since 2025-07-01 | — | — | Not classified | — | Montana Healthcare Programs fee schedule |
| 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- |
| NevadaAny qualified provider (rate does not vary by provider) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules) | $700.00since 2002-01-01 | — | — | Plans must pay at least this | — | Provider Type 23 Hearing Aid Dispenser & |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $679.00since 2010-01-01 | Each | — | Plans negotiate; applies out of network | — | ODM DMEPOS payment schedule (appendix to |
| South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service) | $582.00since 2024-07-01 | — | — | Not classified | — | SCDHHS Durable Medical Equipment (DME) F |
| 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 |
| KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule) | $65.00since 2006-03-01 | — | — | Paid by the state, outside plans | — | KMAP Fee Schedule MKN Medicaid (FeeSched |
| 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 V5252?
It depends on the state. Of the 12 states with a published fee-for-service rate, the median is $726.00. Oregon pays the most ($1,467.40) and Wisconsin the least ($32.53).
Which state pays the highest Medicaid rate for V5252?
Oregon, at $1,467.40, effective 2024-10-01.
Do managed-care plans pay the same rate for V5252?
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.