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V2531 — Contact lens, scleral, gas permeable, per lens (for contact lens modification, see 92325)

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

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.

V2531 Medicare fee schedule (April 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $650.75 to $715.83 depending on state and rural status.

Former-CBA payment limits: ceiling $799.22 · floor $599.42

StateNon-ruralRural
AK$657.26
AL$670.31
AR$670.24
AZ$650.75
CA$650.75
CO$671.91
CT$683.61
DC$650.75
DE$650.75
FL$670.31
GA$670.31
HI$702.81
IA$662.80
ID$650.75
IL$666.71
IN$666.71
KS$662.80
KY$670.31
LA$670.24
MA$683.61
MD$650.75
ME$683.61
MI$666.71
MN$666.71
MO$662.80
MS$670.31
MT$671.91
NC$670.31
ND$671.91
NE$662.80
NH$683.61
NJ$663.82
NM$670.24
NV$650.75
NY$663.82
OH$666.71
OK$670.24
OR$650.75
PA$650.75
PR$715.83
RI$683.61
SC$670.31
SD$671.91
TN$670.31
TX$670.24
UT$671.91
VA$650.75
VI$715.83
VT$683.61
WA$650.75
WI$666.71
WV$650.75
WY$671.91
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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