MyMedi-AI

V2320 — Trifocal add over 3.25d

HCPCS Level II V-code · short descriptor: “Lens trifocal 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.

V2320 Medicare fee schedule (April 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $21.68 to $116.17 depending on state and rural status.

Former-CBA payment limits: ceiling $85.52 · floor $64.14

StateNon-ruralRural
AK$21.68
AL$64.14
AR$85.52
AZ$64.14
CA$64.14
CO$64.14
CT$64.14
DC$85.52
DE$85.52
FL$64.14
GA$64.14
HI$23.19
IA$85.52
ID$72.58
IL$85.52
IN$85.52
KS$85.52
KY$64.14
LA$85.52
MA$64.14
MD$85.52
ME$64.14
MI$85.52
MN$85.52
MO$85.52
MS$64.14
MT$64.14
NC$64.14
ND$64.14
NE$85.52
NH$64.14
NJ$85.52
NM$85.52
NV$64.14
NY$85.52
OH$85.52
OK$85.52
OR$72.58
PA$85.52
PR$116.17
RI$64.14
SC$64.14
SD$64.14
TN$64.14
TX$85.52
UT$64.14
VA$85.52
VI$85.52
VT$64.14
WA$72.58
WI$85.52
WV$85.52
WY$64.14
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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