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V2512 — Contact lens, gas permeable, bifocal, per lens

HCPCS Level II V-code · short descriptor: “Cntct lens gas permbl bifocl”

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.

V2512 Medicare fee schedule (April 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $230.62 to $434.08 depending on state and rural status.

Former-CBA payment limits: ceiling $307.49 · floor $230.62

StateNon-ruralRural
AK$289.90
AL$230.62
AR$307.49
AZ$271.53
CA$271.53
CO$230.62
CT$272.68
DC$286.17
DE$286.17
FL$230.62
GA$230.62
HI$309.92
IA$282.10
ID$230.62
IL$256.25
IN$256.25
KS$282.10
KY$230.62
LA$307.49
MA$272.68
MD$286.17
ME$272.68
MI$256.25
MN$256.25
MO$282.10
MS$230.62
MT$230.62
NC$230.62
ND$230.62
NE$282.10
NH$272.68
NJ$307.49
NM$307.49
NV$271.53
NY$307.49
OH$256.25
OK$307.49
OR$230.62
PA$286.17
PR$434.08
RI$272.68
SC$230.62
SD$230.62
TN$230.62
TX$307.49
UT$230.62
VA$286.17
VI$307.49
VT$272.68
WA$230.62
WI$256.25
WV$286.17
WY$230.62
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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