Eye exams and vision services: Medicaid rates by state
1 states publish a Medicaid rate for eye exams and vision services, compared at the physician psychologist level. The median is $117.32 per hour; per hour, rates range from $117.32 in Iowa to $117.32 in Iowa.
- States
- 1
- Median per hour
- $117.32
- Highest
- $117.32Iowa
- Lowest
- $117.32Iowa
- Rates on file
- 3,221
Eye exams and vision services: highest and lowest states
Headline rate per state for the same provider level, converted to an hour.
How eye exams and vision services is compared
A billing code alone doesn't make a fair comparison: states bill eye exams and vision services under different codes, units and provider types. This benchmark lines up one comparable rate per state.
- Provider level. States are compared at the physician or licensed psychologist (incl. BCBA-D) level. Rates for other levels on file (any qualified provider, clinical nurse specialist and independent (non-agency) provider) are kept separate, never mixed into this ranking.
- Unit. All 1 states publish their headline rate per 15 min, so the amounts compare directly. The ranking converts every time-based rate to an hour of service, so states that bill by the 15 minutes and by the hour compare directly.
- Variants. 1 of the 1 states publish more than one rate for this service (by modifier, program, setting or provider type); the headline rate is the one that matches the comparison, and the workspace lists every variant.
- Depth. 3,221 rates for this service are on file across all states, versions and provider levels; this page shows one headline rate per state.
Why eye exams and vision services rates differ between states
The highest-paying state, Iowa, pays $117.32 per hour; the lowest, Iowa, pays $117.32 per hour. 0 of the 1 states pay above the median of $117.32 per hour. Common reasons rates for vision & hearing services spread this way:
- Some states buy eyeglasses through a single contracted laboratory, which changes what a provider is paid for the materials.
- Hearing aids and some lenses are priced at invoice or acquisition cost in some states and at a fixed fee in others.
- Adult vision and hearing benefits are optional for states, so coverage, limits and fees vary widely.
Billing notes
Vision and hearing materials are billed per item, per lens or per device, and hearing aids per ear (monaural or binaural).
Frequently asked questions
Which state pays the most for eye exams and vision services?
Iowa: $29.33 per 15 min ($117.32 per hour).
Which state pays the least for eye exams and vision services?
Iowa: $29.33 per 15 min ($117.32 per hour).
What is the average Medicaid rate for eye exams and vision services?
Across 1 states the median is $117.32 per hour, comparing the same provider level in each state. 0 states pay above it.
How are the states compared?
One headline rate per state, matched on the service and the physician or licensed psychologist (incl. BCBA-D) level and converted to an hour of service. Rates for other provider levels and add-ons are not mixed in.
What unit is eye exams and vision services billed in?
All 1 states publish it per 15 min, so the amounts compare directly.
Do managed-care plans pay these rates?
It depends on the state. Each state's managed-care page shows whether plans must pay at least the published rate, follow a state-set rate, or negotiate their own for this service line.