The Rates plan
$29/mo7-day free trialThe table on this page is a common-procedure sample. The full Colorado vision schedule has 167 codes.
- Every code on all 51 published schedules
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Published codes
167
Vision procedures on the 2026 schedule
Median % of Medicare
77.9%
vs national Medicare, GPCI-neutral
PA required
2
codes flagged by the state
Common vision procedures and what Colorado Medicaid pays
A curated sample of recognizable procedures from the 167-code schedule. Rates are the state's published fee-for-service amounts; the percentage compares each rate with the national Medicare amount for the same code.
| Code | Procedure | Colorado rate | % of Medicare |
|---|---|---|---|
| 92002 | Eye exam, new patient, intermediate | $73.77 | 87% |
| 92004 | Eye exam, new patient, comprehensive | $138.50 | 92.6% |
| 92012 | Eye exam, established patient, intermediate | $80.00 | 88.4% |
| 92014 | Eye exam, established patient, comprehensive | $115.48 | 90.8% |
| 92015 | Determination of eyeglass prescription (refraction) | $15.88 | -- |
| 92083 | Visual field examination, extended | $67.62 | 106% |
| 92134 | Retinal imaging (OCT scan) | $39.08 | 119.4% |
| 92250 | Photography of the back of the eye (fundus) | $40.11 | 108.2% |
| 92273 | Full-field electroretinography (ERG) | $110.43 | 89.6% |
| 92283 | Color vision examination, extended | $47.14 | 85.5% |
| 92340 | Fitting of eyeglasses, single vision | $27.53 | -- |
| V2020 | Frames, purchases | $69.58 | 78.7% |
| V2100 | Sphere, single vision, plano to plus or minus 4.00, per lens | $49.47 | 90.8% |
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 * show the schedule's representative published variant.
More Colorado Medicaid fee schedules
- Colorado physician fee schedule · 6,772 codes
- Colorado dme & supplies fee schedule · 2,193 codes
- Colorado lab & imaging fee schedule · 794 codes
- Colorado other services fee schedule · 372 codes
- Colorado anesthesia fee schedule · 275 codes
- Colorado drugs fee schedule · 39 codes
Vision rates in neighboring states
Frequently asked questions
What does Colorado Medicaid pay for vision services and eyewear?
Colorado Medicaid publishes 167 vision procedure rates effective 2026, paying a median 77.9% of the national Medicare amount for the same services. The schedule covers eye exams, refractions, frames, and lenses. The table on this page shows published rates for common procedures; the complete all-codes schedule is available as a CSV download with a ProviderSignal Rates subscription.
How do Colorado's vision rates compare with Medicare?
Across vision codes with a national Medicare comparator, Colorado Medicaid pays a median 77.9% of the Medicare amount (GPCI-neutral national comparison). Individual codes vary widely, so check the per-code percentage in the table.
Do vision services need prior authorization in Colorado?
Colorado publishes prior-authorization flags on its schedule: 2 vision codes are marked as always requiring PA. Codes without a flag carry no published PA indicator.
Where do these rates come from?
Directly from Colorado's published Medicaid fee-for-service schedule (effective 2026), collected and normalized by ProviderSignal across all 50 states + DC. Rates are re-collected on a rolling schedule and this page updates automatically. Procedure descriptions are ProviderSignal's own plain-language labels or public-domain CMS text.
Get an email the next time Colorado changes these rates.