V5258 Medicaid reimbursement rates by state
Hearing aid, digital, binaural, cic. 13 state Medicaid programs publish a fee-for-service rate for V5258 at the physician psychologist level. Rates run from $32.53 in Wisconsin to $2,651.00 in Georgia, with a median of $1,129.79.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 13
- Median rate
- $1,129.79units vary by state
- Highest
- $2,651.00Georgia
- Medicare (non-facility)
- —not on the physician fee schedule
V5258 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 |
|---|---|---|---|---|---|---|
| GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service) | $2,651.00since 2020-04-01 | — | — | Plans negotiate; applies out of network | — | Orthotic and Prosthetic Fee Schedule 2nd |
| IowaAny qualified provider (rate does not vary by provider) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $2,399.00since 2019-05-01 | — | — | Plans must pay at least this | — | Iowa Medicaid fee schedule #17 AUDIOLOGI |
| PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service) | $2,390.00since 2005-12-12 | — | — | Plans negotiate; applies out of network | — | PA DHS PROMISe Outpatient Fee Schedule ( |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $2,350.00since 2008-01-01 | — | — | Plans negotiate; applies out of network | — | DMAS procedure fee file hcpcmedical.csv |
| ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service) | $1,470.98since 2026-07-01 | — | — | Not classified | — | Health First Colorado Physician Fee Sche |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $1,350.90since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | AHCCCS FFS Capped Fee Schedule: Durable |
| 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- |
| ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP) | $600.00since 2016-03-01 | — | — | Not classified | — | CMAP fee schedule: 7/1/2025 MEDS - Heari |
| 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 V5258?
It depends on the state. Of the 13 states with a published fee-for-service rate, the median is $1,129.79. Georgia pays the most ($2,651.00) and Wisconsin the least ($32.53).
Which state pays the highest Medicaid rate for V5258?
Georgia, at $2,651.00, effective 2020-04-01.
Do managed-care plans pay the same rate for V5258?
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.