V2020 Vision svcs frames purchases

Frames, purchases

Medically Unlikely Edits (effective October 1, 2026)

Medicare pricing for V2020

DMEPOS fee schedule, July 2026 (DME26-C)

Physician Fee Schedule (CY 2026, RVU26D)

Status X: statutory exclusion, not paid under the PFS.

Payer policies and prior authorization for V2020

Payer coverage policies that name V2020

V2020 appears in 3 coverage policies from Aetna, Capital Blue Cross.

PayerPolicyRole in policyReviewedDocument
AetnaContact Lenses and Eyeglasses (0126)covered if criteria are metMar 26, 2026payer document
AetnaOrthoptic Vision Therapy (0489)listed, no stance (range V2020-V2025)Jul 28, 2025payer document
Capital Blue CrossIntraocular Lenses, Spectacle Correction, and Iris Prosthesis (MP 6.058)
Procedure codes
covered if criteria are metMar 1, 2026payer document

Medicaid fee-for-service

  • AZ: $95.33 (dme), effective Oct 1, 2026
  • CO: $67.11 (chp_plus, non-facility), effective Jul 1, 2026
  • IN: $76.75 (professional, Advanced Practice Nurse (85%), non-facility), effective Jan 1, 2026
  • KS: $48.53 (default, Exempt Physician), effective Jul 1, 2026
  • KY: $50.00 (vision), effective Jan 1, 2026
  • LA: $17.20 (vision_eyewear), effective Sep 1, 2024
  • MS: $36.73 (comprehensive), effective Jan 1, 1994
  • MT: $14.00 (eyeglasses), effective May 1, 2024
  • ND: $0.00 (physician), effective Aug 1, 2026
  • NE: $49.05 (vision), effective Jul 1, 2026
  • NY: $6.06 (vision, facility), effective Apr 1, 2026
  • OK: $10.00 (dme), effective Aug 1, 2020
  • TX: $41.22 (dmepos_tos_9_e_j_l_and_r, Clinic/Group Practice), effective Sep 1, 2026
  • VA: $45.50 (medical), effective Jul 1, 2022
  • VT: $3.00 (outpatient_hospital_opps), effective Feb 1, 2026
  • WY: $71.65 (professional), effective Jan 1, 2021

From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.