MyMedi-AI

V2530 — Contact lens, scleral, gas impermeable, per lens (for contact lens modification, see 92325)

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

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.

V2530 Medicare fee schedule (October 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $149.75 to $364.07 depending on state and rural status.

Former-CBA payment limits: ceiling $364.07 · floor $273.05

StateNon-ruralRural
AK$149.75—
AL$273.05—
AR$348.04—
AZ$273.05—
CA$273.05—
CO$297.16—
CT$364.07—
DC$312.38—
DE$312.38—
FL$273.05—
GA$273.05—
HI$160.11—
IA$273.05—
ID$273.05—
IL$364.07—
IN$364.07—
KS$273.05—
KY$273.05—
LA$348.04—
MA$364.07—
MD$312.38—
ME$364.07—
MI$364.07—
MN$364.07—
MO$273.05—
MS$273.05—
MT$297.16—
NC$273.05—
ND$297.16—
NE$273.05—
NH$364.07—
NJ$273.05—
NM$348.04—
NV$273.05—
NY$273.05—
OH$364.07—
OK$348.04—
OR$273.05—
PA$312.38—
PR$245.95—
RI$364.07—
SC$273.05—
SD$297.16—
TN$273.05—
TX$348.04—
UT$297.16—
VA$312.38—
VI$273.05—
VT$364.07—
WA$273.05—
WI$364.07—
WV$312.38—
WY$297.16—
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 V2530 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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