`V2299` Lens bifocal speciality

Specialty bifocal (by report)

Medicare coverage: Carrier judgment
Status: active (October 2026 file)

Medically Unlikely Edits (effective October 1, 2026)

Practitioner: max 0 units per day (clinical), rationale: CMS Policy
Outpatient hospital: max 2 units per day (clinical), rationale: Nature of Equipment
DME supplier: max 2 units per day (clinical), rationale: Nature of Equipment

Medicare pricing for V2299

Physician Fee Schedule (CY 2026, RVU26D)

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

Payer policies and prior authorization for V2299

1 of 1 payer prior-auth lists that name V2299 require prior authorization or set conditions: UnitedHealthcare Community Plan.

Payer	Plan	State	Prior auth	Conditions	Since	Source
UnitedHealthcare Community Plan	UnitedHealthcare Community Plan of Hawaii (QUEST Integration)	HI	prior auth under conditions	Age 40+	Oct 1, 2026	Prior authorization requirements for UnitedHealthcare Community Plan of Hawaii Effective October 1, 2026

Payer coverage policies that name V2299

V2299 appears in 3 coverage policies from Aetna.

Payer	Policy	Role in policy	Reviewed	Document
Aetna	Contact Lenses and Eyeglasses (0126)	covered if criteria are met (range V2100-V2499)	Mar 26, 2026	payer document
Aetna	Corneal Remodeling (0023)	listed, no stance (range V2100-V2499)	Oct 9, 2026	payer document
Aetna	Orthoptic Vision Therapy (0489)	listed, no stance (range V2100-V2499)	Jul 28, 2025	payer document

Medicaid fee-for-service

Prior authorization required or conditional in FL, IL, LA, MS, ND, OH, WY.

IL: $0.00 (optometric), effective May 6, 2025
KS: $37.50 (default, Exempt Physician), effective Jul 1, 2007
KY: $43.00 (vision), effective Jan 1, 2026
MT: $20.00 (eyeglasses), effective May 1, 2024
ND: $0.00 (physician), effective Aug 1, 2026
VT: $100.00 (outpatient_hospital_opps), effective Feb 1, 2026
WY: $0.00 (professional), effective Jan 1, 2017

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.

V2299 Lens bifocal speciality