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
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.

V2523 Medicare fee schedule (April 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 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

Bill V2523 with confidence

MyMedi-AI scrubs whole claims against NCCI pairs, MUE limits, modifier rules, and PA flags before you submit — built for DME teams, no PHI stored on our servers.

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, V2523 included, and starter credits via POST /bot-marketplace/register.