Every state, kept current
The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for V5243. Full schedules include every locality, modifier, and age-band variant.
- Every code on all 51 published schedules
- Full-schedule CSV export and state network lists
- Email alerts when a state changes its rates
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Publishing states
11
Median % of Medicare
--
Rate range
$32.53 - $550.00
V5243 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Illinois | $376.00 | -- | -- | 2026 |
| Kansas | $250.00 | -- | -- | 2006 |
| Michigan | $450.00* | -- | Required | 2026 |
| Missouri | $396.64* | -- | Varies | 2019 |
| Montana | $530.22* | -- | Required | 2026 |
| Nebraska | $433.46 | -- | -- | 2026 |
| New Hampshire | $425.18 | -- | Not required | 2026 |
| Nevada | $350.00 | -- | -- | -- |
| Virginia | $550.00 | -- | -- | 2008 |
| Vermont | $450.00 | -- | -- | 2026 |
| Wisconsin | $32.53* | -- | -- | 2022 |
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 hearing codes
- V5008 - Hearing screening
- V5010 - Assessment for hearing aid
- V5011 - Fitting/orientation/checking of hearing aid
- V5014 - Repair/modification of a hearing aid
- V5020 - Conformity evaluation
- V5030 - Hearing aid, monaural, body worn, air conduction
- V5040 - Hearing aid, monaural, body worn, bone conduction
- V5050 - Hearing aid, monaural, in the ear
All 53 codes from V5008 to V5275 or every hearing code by number.
Frequently asked questions
How much does Medicaid pay for V5243?
11 state Medicaid programs publish a fee-for-service rate for V5243 (hearing aid, analog, monaural, itc (in the canal)), ranging from $32.53 in Wisconsin to $550.00 in Virginia. The full table on this page lists every publishing state's current rate.
Which state pays the most for V5243?
Virginia publishes the highest Medicaid rate for V5243 at $550.00. Wisconsin publishes the lowest at $32.53.
Does V5243 require prior authorization under Medicaid?
2 of the 11 publishing states flag V5243 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".