The Rates plan
$29/mo7-day free trialThe table on this page is a common-procedure sample. The full Delaware vision schedule has 129 codes.
- Every code on all 51 published schedules
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Published codes
129
Vision procedures on the 2026 schedule
Median % of Medicare
100.2%
vs national Medicare, GPCI-neutral
Effective vintage
2026
latest effective year on the schedule
Common vision procedures and what Delaware Medicaid pays
A curated sample of recognizable procedures from the 129-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 | Delaware rate | % of Medicare |
|---|---|---|---|
| 92002 | Eye exam, new patient, intermediate | $82.57 | 97.3% |
| 92004 | Eye exam, new patient, comprehensive | $145.78 | 97.4% |
| 92012 | Eye exam, established patient, intermediate | $88.06 | 97.3% |
| 92014 | Eye exam, established patient, comprehensive | $123.89 | 97.4% |
| 92015 | Determination of eyeglass prescription (refraction) | $18.58 | -- |
| 92083 | Visual field examination, extended | $61.99 | 97.2% |
| 92134 | Retinal imaging (OCT scan) | $31.81 | 97.2% |
| 92250 | Photography of the back of the eye (fundus) | $36.05 | 97.2% |
| 92273 | Full-field electroretinography (ERG) | $119.62 | 97.1% |
| 92283 | Color vision examination, extended | $53.40 | 96.9% |
| V2020 | Frames, purchases | $76.76 | 86.8% |
| V2100 | Sphere, single vision, plano to plus or minus 4.00, per lens | $58.92 | 108.1% |
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 Delaware Medicaid fee schedules
- Delaware physician fee schedule · 6,378 codes
- Delaware lab & imaging fee schedule · 2,020 codes
- Delaware dme & supplies fee schedule · 1,164 codes
- Delaware anesthesia fee schedule · 278 codes
- Delaware other services fee schedule · 52 codes
- Delaware behavioral health fee schedule · 36 codes
Vision rates in neighboring states
Frequently asked questions
What does Delaware Medicaid pay for vision services and eyewear?
Delaware Medicaid publishes 129 vision procedure rates effective 2026, paying a median 100.2% 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 Delaware's vision rates compare with Medicare?
Across vision codes with a national Medicare comparator, Delaware Medicaid pays a median 100.2% 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 Delaware?
Delaware does not publish prior-authorization indicators on this fee schedule, so PA requirements must be confirmed through the state's provider manual or portal. Absence of a flag here means "not published", never "no PA required".
Where do these rates come from?
Directly from Delaware'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 Delaware changes these rates.