Indiana Medicaid Vision Fee Schedule 2026

Indiana Medicaid publishes 149 vision procedure rates effective 2026, paying a median 93.1% of the national Medicare amount for the same services. This page shows published rates for common vision procedures with plain-language descriptions and, where a comparator exists, each rate as a percentage of national Medicare.

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The table on this page is a common-procedure sample. The full Indiana vision schedule has 149 codes.

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Published codes

149

Vision procedures on the 2026 schedule

Median % of Medicare

93.1%

vs national Medicare, GPCI-neutral

PA required

1

codes flagged by the state

Common vision procedures and what Indiana Medicaid pays

A curated sample of recognizable procedures from the 149-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.

CodeProcedureIndiana rate% of Medicare
92002Eye exam, new patient, intermediate$78.6492.7%
92004Eye exam, new patient, comprehensive$138.5892.6%
92012Eye exam, established patient, intermediate$82.5391.2%
92014Eye exam, established patient, comprehensive$116.8791.8%
92015Determination of eyeglass prescription (refraction)$17.89--
92083Visual field examination, extended$58.3591.5%
92134Retinal imaging (OCT scan)$37.39114.2%
92250Photography of the back of the eye (fundus)$34.2592.4%
92273Full-field electroretinography (ERG)$115.4593.7%
V2020Frames, purchases$90.29102.1%
V2100Sphere, single vision, plano to plus or minus 4.00, per lens$55.80102.4%

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 Indiana Medicaid fee schedules

Vision rates in neighboring states

Frequently asked questions

What does Indiana Medicaid pay for vision services and eyewear?

Indiana Medicaid publishes 149 vision procedure rates effective 2026, paying a median 93.1% 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 Indiana's vision rates compare with Medicare?

Across vision codes with a national Medicare comparator, Indiana Medicaid pays a median 93.1% 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 Indiana?

Indiana publishes prior-authorization flags on its schedule: 1 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 Indiana'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 Indiana changes these rates.