MyMedi-AI

V2523 — Contact lens, hydrophilic, extended wear, per lens

HCPCS Level II V-code · short descriptor: “Cntct lens hydrophil extend”

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 2026-10-26; 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.

V2523 Medicare fee schedule (October 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $178.06 to $388.84 depending on state and rural status.

Former-CBA payment limits: ceiling $245.80 · floor $184.35

StateNon-ruralRural
AK$178.06—
AL$184.35—
AR$225.33—
AZ$184.35—
CA$184.35—
CO$184.35—
CT$238.20—
DC$231.23—
DE$231.23—
FL$184.35—
GA$184.35—
HI$190.37—
IA$187.02—
ID$188.26—
IL$227.73—
IN$227.73—
KS$187.02—
KY$184.35—
LA$225.33—
MA$238.20—
MD$231.23—
ME$238.20—
MI$227.73—
MN$227.73—
MO$187.02—
MS$184.35—
MT$184.35—
NC$184.35—
ND$184.35—
NE$187.02—
NH$238.20—
NJ$229.77—
NM$225.33—
NV$184.35—
NY$229.77—
OH$227.73—
OK$225.33—
OR$188.26—
PA$231.23—
PR$388.84—
RI$238.20—
SC$184.35—
SD$184.35—
TN$184.35—
TX$225.33—
UT$184.35—
VA$231.23—
VI$229.77—
VT$238.20—
WA$188.26—
WI$227.73—
WV$231.23—
WY$184.35—
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 V2523 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 V2523 with confidence

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