MyMedi-AI

V2430 — Variable asphericity lens, bifocal, full field, glass or plastic, per lens

HCPCS Level II V-code · short descriptor: “Lens variable asphericity bi”

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
MUE unit limit
2
Status
Active (HCPCS Level II October 2026)

Prior authorization

Not on the Medicare required-PA list (CMS Required Prior Authorization List — 74 items in force on 2026-10-25; 8 more from 2026-10-28; sources: CMS list updated 2026-01-13, CMS-6109-N (91 FR 47972)). 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 (CMS Required F2F & WOPD List — 83 items in force on 2026-10-25; 22 more from 2026-10-28; sources: CMS list effective 2026-04-13 (91 FR 1250), CMS-6109-N (91 FR 47972)). The standard written order must reach the supplier before claim submission.

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

V2430 Medicare fee schedule (October 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $132.29 to $251.95 depending on state and rural status.

Former-CBA payment limits: ceiling $176.39 · floor $132.29

StateNon-ruralRural
AK$235.60—
AL$142.90—
AR$149.99—
AZ$176.39—
CA$176.39—
CO$150.52—
CT$134.92—
DC$142.41—
DE$142.41—
FL$142.90—
GA$142.90—
HI$251.95—
IA$132.29—
ID$135.63—
IL$133.24—
IN$133.24—
KS$132.29—
KY$142.90—
LA$149.99—
MA$134.92—
MD$142.41—
ME$134.92—
MI$133.24—
MN$133.24—
MO$132.29—
MS$142.90—
MT$150.52—
NC$142.90—
ND$150.52—
NE$132.29—
NH$134.92—
NJ$176.39—
NM$149.99—
NV$176.39—
NY$176.39—
OH$133.24—
OK$149.99—
OR$135.63—
PA$142.41—
PR$244.67—
RI$134.92—
SC$142.90—
SD$150.52—
TN$142.90—
TX$149.99—
UT$150.52—
VA$142.41—
VI$176.39—
VT$134.92—
WA$135.63—
WI$133.24—
WV$142.41—
WY$150.52—
Amounts are the Medicare DMEPOS fee-schedule allowables effective October 2026 (CMS DMEPOS Fee Schedule October 2026 (DME26-D)). 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.

Unit limit (MUE)

Medicare's Medically Unlikely Edit caps V2430 at 2 units per date of service (clinical). Units above the MUE deny — typically as CO-151. Rationale: Anatomic Consideration.

Common denial codes to watch

Related V-codes

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