The Rates plan
$29/mo7-day free trialThe table on this page is a common-procedure sample. The full West Virginia vision schedule has 66 codes.
- Every code on all 51 published schedules
- Full-schedule CSV export
- Full state Medicaid dental network lists
- Email alerts when a state changes its rates
$29/mo after the trial. Cancel anytime.
Published codes
66
Vision procedures on the 2026 schedule
Median % of Medicare
66.4%
vs national Medicare, GPCI-neutral
Effective vintage
2026
latest effective year on the schedule
Common vision procedures and what West Virginia Medicaid pays
A curated sample of recognizable procedures from the 66-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 | West Virginia rate | % of Medicare |
|---|---|---|---|
| 92002 | Eye exam, new patient, intermediate | $56.61 | 66.7% |
| 92004 | Eye exam, new patient, comprehensive | $100.53 | 67.2% |
| 92012 | Eye exam, established patient, intermediate | $60.27 | 66.6% |
| 92014 | Eye exam, established patient, comprehensive | $85.16 | 66.9% |
| 92015 | Determination of eyeglass prescription (refraction) | $13.42 | -- |
| 92083 | Visual field examination, extended | $42.21 | 66.2% |
| 92134 | Retinal imaging (OCT scan) | $21.72 | 66.4% |
| 92250 | Photography of the back of the eye (fundus) | $24.89 | 67.1% |
| 92273 | Full-field electroretinography (ERG) | $80.52 | 65.3% |
| 92283 | Color vision examination, extended | $35.87 | 65.1% |
| 92340 | Fitting of eyeglasses, single vision | $23.91 | -- |
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 West Virginia Medicaid fee schedules
- West Virginia physician fee schedule · 6,891 codes
- West Virginia lab & imaging fee schedule · 2,101 codes
- West Virginia dme & supplies fee schedule · 1,528 codes
- West Virginia other services fee schedule · 299 codes
- West Virginia anesthesia fee schedule · 286 codes
- West Virginia behavioral health fee schedule · 25 codes
Vision rates in neighboring states
Frequently asked questions
What does West Virginia Medicaid pay for vision services and eyewear?
West Virginia Medicaid publishes 66 vision procedure rates effective 2026, paying a median 66.4% 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 West Virginia's vision rates compare with Medicare?
Across vision codes with a national Medicare comparator, West Virginia Medicaid pays a median 66.4% 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 West Virginia?
West Virginia 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 West Virginia'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 West Virginia changes these rates.