The Rates plan
$29/mo7-day free trialThe table on this page is a common-procedure sample. The full Missouri vision schedule has 147 codes.
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Published codes
147
Vision procedures on the 2026 schedule
Median % of Medicare
67.6%
vs national Medicare, GPCI-neutral
PA required
97
+34 conditional or varies
Common vision procedures and what Missouri Medicaid pays
A curated sample of recognizable procedures from the 147-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 | Missouri rate | % of Medicare |
|---|---|---|---|
| 92002 | Eye exam, new patient, intermediate | $64.55 | 76.1% |
| 92004 | Eye exam, new patient, comprehensive | $112.23 | 75% |
| 92012 | Eye exam, established patient, intermediate | $66.86 | 73.9% |
| 92014 | Eye exam, established patient, comprehensive | $66.86 | 52.5% |
| 92015 | Determination of eyeglass prescription (refraction) | $5.35 | -- |
| 92083 | Visual field examination, extended | $46.88 | 73.5% |
| 92134 | Retinal imaging (OCT scan) | $30.38 | 92.8% |
| 92250 | Photography of the back of the eye (fundus) | $27.82 | 75% |
| 92273 | Full-field electroretinography (ERG) | $126.37 | 102.5% |
| 92283 | Color vision examination, extended | $40.34 | 73.2% |
| V2020 | Frames, purchases | $59.01 | 66.7% |
| V2100 | Sphere, single vision, plano to plus or minus 4.00, per lens | $34.99* | 64.2% |
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 Missouri Medicaid fee schedules
- Missouri physician fee schedule · 6,776 codes
- Missouri lab & imaging fee schedule · 2,806 codes
- Missouri dme & supplies fee schedule · 1,621 codes
- Missouri other services fee schedule · 603 codes
- Missouri anesthesia fee schedule · 275 codes
- Missouri behavioral health fee schedule · 61 codes
Vision rates in neighboring states
Frequently asked questions
What does Missouri Medicaid pay for vision services and eyewear?
Missouri Medicaid publishes 147 vision procedure rates effective 2026, paying a median 67.6% 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 Missouri's vision rates compare with Medicare?
Across vision codes with a national Medicare comparator, Missouri Medicaid pays a median 67.6% 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 Missouri?
Missouri publishes prior-authorization flags on its schedule: 97 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 Missouri'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 Missouri changes these rates.