Maryland Medicaid Vision Fee Schedule 2026

Maryland Medicaid publishes 7 vision procedure rates effective 2026, paying a median 75.4% 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 Maryland vision schedule has 7 codes.

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Published codes

7

Vision procedures on the 2026 schedule

Median % of Medicare

75.4%

vs national Medicare, GPCI-neutral

PA required

1

codes flagged by the state

Maryland's published Medicaid fee schedule covers durable medical equipment, prosthetics, orthotics, and supplies. Other service categories are paid through managed care and are not published as FFS rates.

Common vision procedures and what Maryland Medicaid pays

A curated sample of recognizable procedures from the 7-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.

CodeProcedureMaryland rate% of Medicare

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 Maryland Medicaid fee schedules

Vision rates in neighboring states

Frequently asked questions

What does Maryland Medicaid pay for vision services and eyewear?

Maryland Medicaid publishes 7 vision procedure rates effective 2026, paying a median 75.4% 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 Maryland's vision rates compare with Medicare?

Across vision codes with a national Medicare comparator, Maryland Medicaid pays a median 75.4% 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 Maryland?

Maryland 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 Maryland'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 Maryland changes these rates.