Utah Medicaid Vision Fee Schedule 2026

Utah Medicaid publishes 122 vision procedure rates effective 2026, paying a median 74.3% 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 Utah vision schedule has 122 codes.

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Published codes

122

Vision procedures on the 2026 schedule

Median % of Medicare

74.3%

vs national Medicare, GPCI-neutral

PA required

10

codes flagged by the state

Common vision procedures and what Utah Medicaid pays

A curated sample of recognizable procedures from the 122-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.

CodeProcedureUtah rate% of Medicare
92002Eye exam, new patient, intermediate$63.96*75.4%
92004Eye exam, new patient, comprehensive$113.23*75.7%
92012Eye exam, established patient, intermediate$68.21*75.4%
92014Eye exam, established patient, comprehensive$96.09*75.5%
92015Determination of eyeglass prescription (refraction)$5.00*--
92083Visual field examination, extended$47.82*75%
92134Retinal imaging (OCT scan)$24.62*75.2%
92250Photography of the back of the eye (fundus)$27.95*75.4%
92273Full-field electroretinography (ERG)$91.97*74.6%
92283Color vision examination, extended$40.91*74.2%
V2020Frames, purchases$64.37*72.8%
V2100Sphere, single vision, plano to plus or minus 4.00, per lens$45.77*84%

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 Utah Medicaid fee schedules

Vision rates in neighboring states

Frequently asked questions

What does Utah Medicaid pay for vision services and eyewear?

Utah Medicaid publishes 122 vision procedure rates effective 2026, paying a median 74.3% 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 Utah's vision rates compare with Medicare?

Across vision codes with a national Medicare comparator, Utah Medicaid pays a median 74.3% 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 Utah?

Utah publishes prior-authorization flags on its schedule: 10 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 Utah'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 Utah changes these rates.