The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for 92325. Full schedules include every locality, modifier, and age-band variant.
- Every code on all 51 published schedules
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Publishing states
27
Median % of Medicare
81.5%
Rate range
$10.07 - $61.30
92325 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Arizona | $46.02 | 98.4% | -- | 2025 |
| California | $12.21 | 26.1% | -- | 2026 |
| Colorado | $39.76 | 85% | -- | 2026 |
| Connecticut | $28.61 | 61.2% | -- | 2026 |
| District of Columbia | $44.05 | 94.2% | Not required | 2026 |
| Hawaii | $46.85 | 100.2% | -- | 2025 |
| Iowa | $11.09 | 23.7% | -- | 2024 |
| Indiana | $40.12 | 85.8% | -- | 2026 |
| Kansas | $23.64 | 50.6% | -- | 2024 |
| Massachusetts | $36.09 | 77.2% | -- | 2026 |
| Maine | $31.07 | 66.4% | -- | 2026 |
| Minnesota | $36.79 | 78.7% | Conditional | 2026 |
| Mississippi | $34.64 | 74.1% | -- | 2020 |
| Montana | $61.30 | 131.1% | -- | 2026 |
| North Dakota | $52.19 | 111.6% | Required | 2026 |
| Nebraska | $38.38 | 82.1% | -- | 2026 |
| New Hampshire | $10.07 | 21.5% | Not required | 2026 |
| New Mexico | $54.98 | 117.6% | -- | 2025 |
| Nevada | $39.13 | 83.7% | -- | 2024 |
| Ohio | $21.18 | 45.3% | -- | 2024 |
| Oklahoma | $38.99 | 83.4% | -- | 2026 |
| Oregon | $38.10* | 81.5% | -- | 2026 |
| Texas | $36.35* | 77.7% | -- | 2023 |
| Utah | $34.49* | 73.8% | Not required | 2026 |
| Vermont | $39.50 | 84.5% | -- | 2026 |
| West Virginia | $29.77 | 63.7% | -- | 2026 |
| Wyoming | $39.23* | 83.9% | -- | 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 92325?
27 state Medicaid programs publish a fee-for-service rate for 92325 (contact lens modification), ranging from $10.07 in New Hampshire to $61.30 in Montana, with a median of 81.5% of the national Medicare amount. The full table on this page lists every publishing state's current rate.
Which state pays the most for 92325?
Montana publishes the highest Medicaid rate for 92325 at $61.30 (131.1% of the national Medicare amount). New Hampshire publishes the lowest at $10.07.
Does 92325 require prior authorization under Medicaid?
2 of the 27 publishing states flag 92325 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".