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V5266 Medicaid reimbursement rates by state

Battery for use in hearing device. 39 state Medicaid programs publish a fee-for-service rate for V5266 at the physician psychologist level. Rates run from $0.50 in Washington to $30.02 in North Carolina, with a median of $1.25.

Data as of 2026-10-05. Every rate links to the official document it came from.

States publishing
39
Median rate
$1.25units vary by state
Highest
$30.02North Carolina
Medicare (non-facility)
—not on the physician fee schedule

V5266 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.

StateMedicaid rateUnitPer hourManaged-care plans% of MedicareSource
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$30.02⚠ over 3× mediansince 2025-10-01——Plans negotiate; applies out of network—NC Medicaid fee schedule 'Hearing Aid Pr
MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service)$21.42⚠ over 3× mediansince 2026-01-01——Not classified—MaineCare Fee Schedule (MaineCare UCR, H
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$6.54since 2026-01-01unit—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)$5.96⚠ over 3× mediansince 2011-08-01——Plans negotiate; applies out of network—Provider Type 33, Durable Medical Equipm
ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service)$5.64⚠ over 3× mediansince 2026-07-01——Not classified—Health First Colorado Physician Fee Sche
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$5.40⚠ over 3× mediansince 2016-07-01——Plans negotiate; applies out of network—Orthotic and Prosthetic Fee Schedule - E
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$5.36⚠ over 3× mediansince 2026-10-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Durable
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$5.16⚠ over 3× mediansince 2019-07-01——Plans negotiate; applies out of network—MO HealthNet fee schedule: Durable Medic
New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS)$3.72since 2021-01-01——Plans negotiate; applies out of network—2026 Fee Schedule - Covered Procedures R
West VirginiaAny qualified provider (rate does not vary by provider) · West Virginia Medicaid (fee-for-service, Bureau for Medical Services)$2.25since 2026-04-01——Plans must pay at least this—BMS DME 2026 Rural Fee Schedule Effectiv
South DakotaAny qualified provider (rate does not vary by provider) · South Dakota Medicaid (fee-for-service, DSS Division of Medical Services)$2.01since 2026-07-01——Not classified—South Dakota Medicaid DME fee schedule (
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$2.00since 2022-01-01——Plans negotiate; applies out of network—KY Medicaid Audiology fee schedule (2022
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$1.99since 2009-01-01——Plans negotiate; applies out of network—OHP FFS medical-dental fee schedule (fee
IowaAny qualified provider (rate does not vary by provider) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$1.79since 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)$1.75since 2002-01-01——Paid by the state, outside plans—KMAP Fee Schedule MKN Medicaid (FeeSched
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$1.67since 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)$1.66since 2025-01-01——Plans must pay at least this—New Mexico Medicaid Fee for Service HCPC
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$1.52since 2019-07-24——Plans negotiate; applies out of network—HFS DME Fee Schedule (effective 2019-07-
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$1.42since 2025-09-01——Plans negotiate; applies out of network—MDHHS Hearing Aid Dealers Fee Schedule d
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$1.25since 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service)$1.25since 2005-12-12——Plans negotiate; applies out of network—PA DHS PROMISe Outpatient Fee Schedule (
HawaiiAny qualified provider (rate does not vary by provider) · Hawaii Medicaid (Med-QUEST) fee-for-service$1.25since 2024-03-04——Plans negotiate; applies out of network—Medicaid Fee-For-Service (FFS) Fee Sched
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$1.24since 2025-01-01——Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
WyomingAny qualified provider (rate does not vary by provider) · Wyoming Medicaid (fee-for-service, Department of Health)$1.18since 2021-07-01——Not classified—Wyoming Medicaid Downloadable Fee Schedu
VermontAny qualified provider (rate does not vary by provider) · Vermont Medicaid (fee-for-service, DVHA)$1.10since 2023-03-01——Not classified—Vermont Medicaid Fee Schedule - DME Code
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$1.03since 2008-07-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Supplies
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Birth to Three (early intervention) Medicaid billing$1.00since 2017-11-01——Not classified—CMAP fee schedule: 7/1/2026 Birth to Thr
UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan)$1.00since 2002-01-01——Plans negotiate; applies out of network—Utah Medicaid Coverage and Reimbursement
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$1.00since 2004-01-01——Plans negotiate; applies out of network—DMAS procedure fee file hcpcmedical.csv
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$0.97since 2010-01-01Each—Plans negotiate; applies out of network—ODM DMEPOS payment schedule (appendix to
IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell)$0.96since 2025-09-01——Not classified—Idaho Medicaid Numerical Fee Schedule Ju
AlaskaAny qualified provider (rate does not vary by provider) · Alaska Medicaid (fee-for-service, Department of Health)$0.90since 2026-07-01——Not classified—Alaska Medicaid Audiology Fee Schedule S
New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service)$0.85since 2025-04-01——Plans negotiate; applies out of network—eMedNY NYS Medicaid DMEPOS Fee Schedule
TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP)$0.82since 2018-07-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Physi
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$0.80since 2025-01-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$0.80since 2024-07-01——Not classified—SCDHHS Durable Medical Equipment (DME) F
LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service)$0.78since 2012-07-01——Plans must pay at least this—Louisiana Medicaid Durable Medical Equip
OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA)$0.57since 2020-08-01——Plans must pay at least this—SoonerCare Durable Medical Equipment Rat
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$0.50since 2021-07-01——Plans negotiate; applies out of network—HCA Hearing hardware fee schedule (heari

Rates marked ⚠ are more than three times the median for the same unit; they are published as shown but often reflect an office (non-facility) fee or a different scope of service. 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 V5266?

It depends on the state. Of the 39 states with a published fee-for-service rate, the median is $1.25. North Carolina pays the most ($30.02) and Washington the least ($0.50).

Which state pays the highest Medicaid rate for V5266?

North Carolina, at $30.02, effective 2025-10-01.

Do managed-care plans pay the same rate for V5266?

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

V2623Prosthetic eye, plastic, custom · 45 statesV2624Polishing/resurfacing of ocular prosthesis · 45 statesV2625Enlargement of ocular prosthesis · 44 states92609Therapy using a communication device · 43 statesV2626Reduction of ocular prosthesis · 43 statesV2628Fabrication and fitting of ocular conformer · 43 statesV2627Scleral cover shell · 42 statesV5264Ear mold/insert, not disposable, any type · 40 statesV2020Frames, purchases · 37 statesV2100Sphere, single vision, plano to plus or minus 4.00, per lens · 36 statesV2101Sphere, single vision · 36 statesV2102Sphere, single vision · 36 states
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Medicaid rates by state
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