MyMedi-AI

V2502 — Contact lens, pmma, bifocal, per lens

HCPCS Level II V-code · short descriptor: “Contact lens pmma bifocal”

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.

V2502 Medicare fee schedule (October 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $186.72 to $434.08 depending on state and rural status.

Former-CBA payment limits: ceiling $248.97 · floor $186.72

StateNon-ruralRural
AK$274.48—
AL$186.72—
AR$186.72—
AZ$247.73—
CA$247.73—
CO$209.13—
CT$245.12—
DC$237.35—
DE$237.35—
FL$186.72—
GA$186.72—
HI$293.47—
IA$219.90—
ID$186.72—
IL$216.59—
IN$216.59—
KS$219.90—
KY$186.72—
LA$186.72—
MA$245.12—
MD$237.35—
ME$245.12—
MI$216.59—
MN$216.59—
MO$219.90—
MS$186.72—
MT$209.13—
NC$186.72—
ND$209.13—
NE$219.90—
NH$245.12—
NJ$248.97—
NM$186.72—
NV$247.73—
NY$248.97—
OH$216.59—
OK$186.72—
OR$186.72—
PA$237.35—
PR$434.08—
RI$245.12—
SC$186.72—
SD$209.13—
TN$186.72—
TX$186.72—
UT$209.13—
VA$237.35—
VI$248.97—
VT$245.12—
WA$186.72—
WI$216.59—
WV$237.35—
WY$209.13—
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 V2502 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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