The Rates plan
$29/mo7-day free trialThe table on this page is a common-procedure sample. The full Utah vision schedule has 122 codes.
- Every code on all 51 published schedules
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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.
| Code | Procedure | Utah rate | % of Medicare |
|---|---|---|---|
| 92002 | Eye exam, new patient, intermediate | $63.96* | 75.4% |
| 92004 | Eye exam, new patient, comprehensive | $113.23* | 75.7% |
| 92012 | Eye exam, established patient, intermediate | $68.21* | 75.4% |
| 92014 | Eye exam, established patient, comprehensive | $96.09* | 75.5% |
| 92015 | Determination of eyeglass prescription (refraction) | $5.00* | -- |
| 92083 | Visual field examination, extended | $47.82* | 75% |
| 92134 | Retinal imaging (OCT scan) | $24.62* | 75.2% |
| 92250 | Photography of the back of the eye (fundus) | $27.95* | 75.4% |
| 92273 | Full-field electroretinography (ERG) | $91.97* | 74.6% |
| 92283 | Color vision examination, extended | $40.91* | 74.2% |
| V2020 | Frames, purchases | $64.37* | 72.8% |
| V2100 | Sphere, 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
- Utah physician fee schedule · 6,362 codes
- Utah lab & imaging fee schedule · 1,885 codes
- Utah dme & supplies fee schedule · 1,646 codes
- Utah drugs fee schedule · 739 codes
- Utah other services fee schedule · 626 codes
- Utah behavioral health fee schedule · 53 codes
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.