MyMedi-AI

V2220 — Bifocal add over 3.25d

HCPCS Level II V-code · short descriptor: “Lens bifocal add over 3.25d”

Code system
HCPCS Level II
Family
V — Vision & hearing services
Medicare coverage status
Carrier judgment — coverage decided by the DME MAC
DMEPOS payment category
Prosthetics & orthotics
Prior authorization
Not on Medicare required-PA list
Face-to-face & WOPD
Not on the required list
Status
Active (April 2026 HCPCS)

Prior authorization

Not on the Medicare required-PA list as of the January 13, 2026 update (74 items). Medicare Advantage and commercial plans set their own prior-authorization rules for this code — verify per plan before delivery.

Order readiness — what the written order must contain

Every Medicare DMEPOS claim needs a Standard Written Order with all six elements (42 CFR 410.38(d)):

  • Beneficiary name or Medicare Beneficiary Identifier (MBI) (42 CFR 410.38(d)(1)(i)(A))
  • General description of the item (42 CFR 410.38(d)(1)(i)(B))
  • Quantity to be dispensed, if applicable (42 CFR 410.38(d)(1)(i)(C))
  • Order date (42 CFR 410.38(d)(1)(i)(D))
  • Treating practitioner name or NPI (42 CFR 410.38(d)(1)(i)(E))
  • Treating practitioner signature (42 CFR 410.38(d)(1)(i)(F))

Not on the F2F/WOPD list (April 13, 2026 update — 83 items). The standard written order must reach the supplier before claim submission.

Blank requirements checklist only — MyMedi-AI never collects or stores completed orders.

V2220 Medicare fee schedule (April 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $44.21 to $96.81 depending on state and rural status.

Former-CBA payment limits: ceiling $58.94 · floor $44.21

StateNon-ruralRural
AK$51.33
AL$44.21
AR$57.62
AZ$51.51
CA$51.51
CO$45.72
CT$44.21
DC$58.94
DE$58.94
FL$44.21
GA$44.21
HI$54.91
IA$58.94
ID$44.21
IL$54.22
IN$54.22
KS$58.94
KY$44.21
LA$57.62
MA$44.21
MD$58.94
ME$44.21
MI$54.22
MN$54.22
MO$58.94
MS$44.21
MT$45.72
NC$44.21
ND$45.72
NE$58.94
NH$44.21
NJ$58.94
NM$57.62
NV$51.51
NY$58.94
OH$54.22
OK$57.62
OR$44.21
PA$58.94
PR$96.81
RI$44.21
SC$44.21
SD$45.72
TN$44.21
TX$57.62
UT$45.72
VA$58.94
VI$58.94
VT$44.21
WA$44.21
WI$54.22
WV$58.94
WY$45.72
Amounts are the Medicare DMEPOS fee-schedule allowables effective April 2026. Medicare typically pays 80% of the allowable after the Part B deductible; the patient owes 20%. A 2% sequestration reduction applies to the Medicare share. Former competitive-bidding-area adjustments and non-continental rates can differ — verify with your DME MAC.

Common denial codes to watch

Related V-codes

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