The Rates plan
$29/mo7-day free trialThe table on this page is a common-procedure sample. The full New York vision schedule has 99 codes.
- Every code on all 51 published schedules
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Published codes
99
Vision procedures on the 2026 schedule
Median % of Medicare
49.7%
vs national Medicare, GPCI-neutral
Effective vintage
2026
latest effective year on the schedule
Common vision procedures and what New York Medicaid pays
A curated sample of recognizable procedures from the 99-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 | New York rate | % of Medicare |
|---|---|---|---|
| 92002 | Eye exam, new patient, intermediate | $76.10 | 89.7% |
| 92004 | Eye exam, new patient, comprehensive | $131.12 | 87.6% |
| 92012 | Eye exam, established patient, intermediate | $78.76 | 87% |
| 92014 | Eye exam, established patient, comprehensive | $111.18 | 87.4% |
| 92083 | Visual field examination, extended | $59.12 | 92.7% |
| 92134 | Retinal imaging (OCT scan) | $35.74 | 109.2% |
| 92250 | Photography of the back of the eye (fundus) | $55.79 | 150.5% |
| 92273 | Full-field electroretinography (ERG) | $113.06 | 91.7% |
| 92340 | Fitting of eyeglasses, single vision | $15.15 | -- |
| V2020 | Frames, purchases | $6.06 | 6.9% |
| V2100 | Sphere, single vision, plano to plus or minus 4.00, per lens | $5.05 | 9.3% |
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 New York Medicaid fee schedules
- New York physician fee schedule · 6,167 codes
- New York dme & supplies fee schedule · 1,599 codes
- New York lab & imaging fee schedule · 627 codes
- New York other services fee schedule · 37 codes
- New York hearing fee schedule · 22 codes
- New York transport fee schedule · 20 codes
Vision rates in neighboring states
Frequently asked questions
What does New York Medicaid pay for vision services and eyewear?
New York Medicaid publishes 99 vision procedure rates effective 2026, paying a median 49.7% 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 New York's vision rates compare with Medicare?
Across vision codes with a national Medicare comparator, New York Medicaid pays a median 49.7% 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 New York?
New York 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 New York'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 New York changes these rates.