The Rates plan
$29/mo7-day free trialThe table on this page is a common-procedure sample. The full Wisconsin vision schedule has 144 codes.
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Published codes
144
Vision procedures on the 2025 schedule
Median % of Medicare
18.7%
vs national Medicare, GPCI-neutral
Effective vintage
2025
latest effective year on the schedule
Common vision procedures and what Wisconsin Medicaid pays
A curated sample of recognizable procedures from the 144-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 | Wisconsin rate | % of Medicare |
|---|---|---|---|
| 92002 | Eye exam, new patient, intermediate | $36.97 | 43.6% |
| 92004 | Eye exam, new patient, comprehensive | $44.33 | 29.6% |
| 92012 | Eye exam, established patient, intermediate | $29.99 | 33.1% |
| 92014 | Eye exam, established patient, comprehensive | $44.54 | 35% |
| 92015 | Determination of eyeglass prescription (refraction) | $9.97 | -- |
| 92083 | Visual field examination, extended | $29.93 | 46.9% |
| 92134 | Retinal imaging (OCT scan) | $32.08 | 98% |
| 92250 | Photography of the back of the eye (fundus) | $24.91 | 67.2% |
| 92273 | Full-field electroretinography (ERG) | $104.80 | 85% |
| 92283 | Color vision examination, extended | $16.20 | 29.4% |
| 92340 | Fitting of eyeglasses, single vision | $22.51 | -- |
| V2020 | Frames, purchases | $5.79 | 6.5% |
| V2100 | Sphere, single vision, plano to plus or minus 4.00, per lens | $10.49 | 19.3% |
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 Wisconsin Medicaid fee schedules
- Wisconsin physician fee schedule · 6,678 codes
- Wisconsin lab & imaging fee schedule · 2,101 codes
- Wisconsin dme & supplies fee schedule · 1,837 codes
- Wisconsin drugs fee schedule · 973 codes
- Wisconsin other services fee schedule · 263 codes
- Wisconsin hearing fee schedule · 47 codes
Vision rates in neighboring states
Frequently asked questions
What does Wisconsin Medicaid pay for vision services and eyewear?
Wisconsin Medicaid publishes 144 vision procedure rates effective 2025, paying a median 18.7% 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 Wisconsin's vision rates compare with Medicare?
Across vision codes with a national Medicare comparator, Wisconsin Medicaid pays a median 18.7% 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 Wisconsin?
Wisconsin 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 Wisconsin's published Medicaid fee-for-service schedule (effective 2025), 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 Wisconsin changes these rates.