MyMedi-AI

V2520 — Contact lens, hydrophilic, spherical, per lens

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

Code system
HCPCS Level II
Family
V — Vision & hearing services
Medicare coverage status
Special coverage instructions apply
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.

V2520 Medicare fee schedule (October 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $119.79 to $387.16 depending on state and rural status.

Former-CBA payment limits: ceiling $170.22 · floor $127.67

StateNon-ruralRural
AK$119.79—
AL$127.67—
AR$154.56—
AZ$127.67—
CA$127.67—
CO$127.67—
CT$150.28—
DC$166.18—
DE$166.18—
FL$127.67—
GA$127.67—
HI$128.04—
IA$149.97—
ID$143.18—
IL$149.66—
IN$149.66—
KS$149.97—
KY$127.67—
LA$154.56—
MA$150.28—
MD$166.18—
ME$150.28—
MI$149.66—
MN$149.66—
MO$149.97—
MS$127.67—
MT$127.67—
NC$127.67—
ND$127.67—
NE$149.97—
NH$150.28—
NJ$170.22—
NM$154.56—
NV$127.67—
NY$170.22—
OH$149.66—
OK$154.56—
OR$143.18—
PA$166.18—
PR$387.16—
RI$150.28—
SC$127.67—
SD$127.67—
TN$127.67—
TX$154.56—
UT$127.67—
VA$166.18—
VI$170.22—
VT$150.28—
WA$143.18—
WI$149.66—
WV$166.18—
WY$127.67—
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 V2520 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

Bill V2520 with confidence

Track prior-authorization requests with AI pre-fill and deadline tracking, and draft PA appeal letters — built for DME teams, PHI-free: no patient data is collected or stored.

Start free trial   Run a CMS-0057-F readiness check

Prefer DIY compliance? Self-audit documentation kits for DME suppliers →

Building an AI agent? Try the agent API in the playground — free PA-required lookups, V2520 included, and starter credits via POST /bot-marketplace/register.