The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for 92072. Full schedules include every locality, modifier, and age-band variant.
- Every code on all 51 published schedules
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Publishing states
41
Median % of Medicare
83.1%
Rate range
$40.61 - $216.94
92072 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Alaska | $216.94 | 180.4% | -- | 2026 |
| Alabama | $78.09 | 64.9% | -- | 2026 |
| Arizona | $127.26 | 105.8% | -- | 2025 |
| California | $101.93 | 84.8% | -- | 2026 |
| Colorado | $107.99 | 89.8% | -- | 2026 |
| Connecticut | $75.75 | 63% | -- | 2026 |
| District of Columbia | $106.94 | 88.9% | Not required | 2026 |
| Georgia | $101.70 | 84.6% | -- | 2026 |
| Hawaii | $95.02 | 79% | -- | 2025 |
| Iowa | $93.24 | 77.5% | -- | 2024 |
| Idaho | $99.88 | 83.1% | Not required | 2026 |
| Indiana | $117.35 | 97.6% | -- | 2025 |
| Kansas | $75.71 | 63% | -- | 2024 |
| Kentucky | $96.16 | 80% | -- | 2026 |
| Massachusetts | $95.78 | 79.7% | -- | 2026 |
| Maine | $83.73 | 69.6% | -- | 2026 |
| Michigan | $76.68 | 63.8% | -- | 2026 |
| Minnesota | $93.65 | 77.9% | Conditional | 2026 |
| Missouri | $95.63 | 79.5% | Varies | 2022 |
| Mississippi | $108.13 | 89.9% | -- | 2020 |
| Montana | $168.02 | 139.7% | -- | 2026 |
| North Carolina | $68.22 | 56.7% | -- | 2025 |
| North Dakota | $134.80 | 112.1% | Required | 2026 |
| Nebraska | $153.55 | 127.7% | -- | 2026 |
| New Hampshire | $57.33 | 47.7% | Not required | 2026 |
| New Jersey | $60.79 | 50.6% | Not required | 2026 |
| New Mexico | $175.51 | 146% | -- | 2025 |
| Nevada | $128.32 | 106.7% | -- | 2024 |
| New York | $110.46 | 91.9% | -- | 2026 |
| Ohio | $40.61 | 33.8% | -- | 2024 |
| Oklahoma | $106.83 | 88.8% | -- | 2026 |
| Oregon | $97.84* | 81.4% | -- | 2026 |
| South Carolina | $83.12 | 69.1% | -- | 2024 |
| Texas | $101.31* | 84.3% | -- | 2015 |
| Utah | $91.74* | 76.3% | Required | 2026 |
| Virginia | $104.17* | 86.6% | -- | 2026 |
| Vermont | $101.68 | 84.6% | -- | 2026 |
| Washington | $73.00 | 60.7% | -- | 2026 |
| Wisconsin | $108.18 | 90% | -- | 2012 |
| West Virginia | $81.50 | 67.8% | -- | 2026 |
| Wyoming | $107.57 | 89.5% | -- | 2026 |
Published Medicaid fee-for-service schedule amounts, not a coverage or eligibility guarantee. Managed-care plan rates can differ. Where no prior-authorization flag is shown, the state does not publish one. Rows marked * are representative published variants or methodology-derived rates. "--" in the prior-auth column means the state publishes no PA flag.
Related vision codes
- 92002 - Eye exam, new patient, intermediate
- 92004 - Eye exam, new patient, comprehensive
- 92012 - Eye exam, established patient, intermediate
- 92014 - Eye exam, established patient, comprehensive
- 92015 - Determination of eyeglass prescription (refraction)
- 92018 - Eye exam under general anesthesia, complete
- 92019 - Eye exam under general anesthesia, limited
- 92020 - Gonioscopy (eye drainage angle exam)
Frequently asked questions
How much does Medicaid pay for 92072?
41 state Medicaid programs publish a fee-for-service rate for 92072 (contact lens fitting for keratoconus, first), ranging from $40.61 in Ohio to $216.94 in Alaska, with a median of 83.1% of the national Medicare amount. The full table on this page lists every publishing state's current rate.
Which state pays the most for 92072?
Alaska publishes the highest Medicaid rate for 92072 at $216.94 (180.4% of the national Medicare amount). Ohio publishes the lowest at $40.61.
Does 92072 require prior authorization under Medicaid?
3 of the 41 publishing states flag 92072 as requiring prior authorization (always or conditionally) on their fee schedules. States without a flag publish no PA indicator for this code - that means "not published", not "no PA required".