V5260 Medicaid reimbursement rates by state
Hearing aid, digital, binaural, ite. 20 state Medicaid programs publish a fee-for-service rate for V5260 at the physician psychologist level. Rates run from $32.53 in Wisconsin to $3,200.00 in Mississippi, with a median of $1,201.36.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 20
- Median rate
- $1,201.36units vary by state
- Highest
- $3,200.00Mississippi
- Medicare (non-facility)
- —not on the physician fee schedule
V5260 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 |
|---|---|---|---|---|---|---|
| MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service) | $3,200.00since 2013-12-01 | — | — | Plans must pay at least this | — | DOM Comprehensive Fee Schedule, Septembe |
| 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 |
| 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 |
| IowaAny qualified provider (rate does not vary by provider) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $1,717.54since 2019-05-01 | — | — | Plans must pay at least this | — | Iowa Medicaid fee schedule #17 AUDIOLOGI |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $1,545.09since 2026-01-01 | unit | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| 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 |
| 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 |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $1,455.00since 2010-01-01 | Each | — | Plans negotiate; applies out of network | — | ODM DMEPOS payment schedule (appendix to |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $1,272.92since 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 |
| ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP) | $1,000.00since 2017-03-01 | — | — | Not classified | — | CMAP fee schedule: 7/1/2025 MEDS - Heari |
| FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service) | $996.09since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | Hearing Services Fee Schedule (AHCA Upda |
| WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service | $956.59since 2021-07-01 | — | — | Plans negotiate; applies out of network | — | HCA Hearing hardware fee schedule (heari |
| 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 & |
| New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service) | $616.10since 2022-04-01 | — | — | Plans negotiate; applies out of network | — | eMedNY NYS Medicaid Hearing Aid / Audiol |
| 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 V5260?
It depends on the state. Of the 20 states with a published fee-for-service rate, the median is $1,201.36. Mississippi pays the most ($3,200.00) and Wisconsin the least ($32.53).
Which state pays the highest Medicaid rate for V5260?
Mississippi, at $3,200.00, effective 2013-12-01.
Do managed-care plans pay the same rate for V5260?
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
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Track V5260 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.