The Rates plan
$29/mo7-day free trialThe table on this page is a common-procedure sample. The full South Carolina vision schedule has 113 codes.
- Every code on all 51 published schedules
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Published codes
113
Vision procedures on the 2026 schedule
Median % of Medicare
54.3%
vs national Medicare, GPCI-neutral
Effective vintage
2026
latest effective year on the schedule
Common vision procedures and what South Carolina Medicaid pays
A curated sample of recognizable procedures from the 113-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 | South Carolina rate | % of Medicare |
|---|---|---|---|
| 92002 | Eye exam, new patient, intermediate | $55.66 | 65.6% |
| 92004 | Eye exam, new patient, comprehensive | $98.25 | 65.7% |
| 92012 | Eye exam, established patient, intermediate | $58.48 | 64.6% |
| 92014 | Eye exam, established patient, comprehensive | $82.81 | 65.1% |
| 92015 | Determination of eyeglass prescription (refraction) | $12.82 | -- |
| 92083 | Visual field examination, extended | $41.30 | 64.7% |
| 92134 | Retinal imaging (OCT scan) | $26.55 | 81.1% |
| 92250 | Photography of the back of the eye (fundus) | $24.32 | 65.6% |
| 92273 | Full-field electroretinography (ERG) | $81.57 | 66.2% |
| 92283 | Color vision examination, extended | $35.67 | 64.7% |
| 92340 | Fitting of eyeglasses, single vision | $22.78 | -- |
| V2020 | Frames, purchases | $52.50 | 59.4% |
| V2100 | Sphere, single vision, plano to plus or minus 4.00, per lens | $5.25 | 9.6% |
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 South Carolina Medicaid fee schedules
- South Carolina physician fee schedule · 6,584 codes
- South Carolina lab & imaging fee schedule · 1,891 codes
- South Carolina dme & supplies fee schedule · 1,486 codes
- South Carolina drugs fee schedule · 788 codes
- South Carolina other services fee schedule · 467 codes
- South Carolina anesthesia fee schedule · 273 codes
Vision rates in neighboring states
Frequently asked questions
What does South Carolina Medicaid pay for vision services and eyewear?
South Carolina Medicaid publishes 113 vision procedure rates effective 2026, paying a median 54.3% 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 South Carolina's vision rates compare with Medicare?
Across vision codes with a national Medicare comparator, South Carolina Medicaid pays a median 54.3% 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 South Carolina?
South Carolina 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 South Carolina'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 South Carolina changes these rates.