MyMedi-AI

V2503 — Contact lens, pmma, color vision deficiency, per lens

HCPCS Level II V-code · short descriptor: “Cntct lens pmma color vision”

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 2026-10-26; 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 2026-10-26; 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.

V2503 Medicare fee schedule (October 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $171.97 to $241.70 depending on state and rural status.

Former-CBA payment limits: ceiling $229.29 · floor $171.97

StateNon-ruralRural
AK$173.37—
AL$178.66—
AR$171.97—
AZ$171.97—
CA$171.97—
CO$171.97—
CT$229.29—
DC$228.83—
DE$228.83—
FL$178.66—
GA$178.66—
HI$185.34—
IA$171.97—
ID$183.45—
IL$209.19—
IN$209.19—
KS$171.97—
KY$178.66—
LA$171.97—
MA$229.29—
MD$228.83—
ME$229.29—
MI$209.19—
MN$209.19—
MO$171.97—
MS$178.66—
MT$171.97—
NC$178.66—
ND$171.97—
NE$171.97—
NH$229.29—
NJ$229.29—
NM$171.97—
NV$171.97—
NY$229.29—
OH$209.19—
OK$171.97—
OR$183.45—
PA$228.83—
PR$241.70—
RI$229.29—
SC$178.66—
SD$171.97—
TN$178.66—
TX$171.97—
UT$171.97—
VA$228.83—
VI$229.29—
VT$229.29—
WA$183.45—
WI$209.19—
WV$228.83—
WY$171.97—
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 V2503 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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