NYS Medicaid Vision Care Codes Manual – Reminder on Billing for Contact Lens Fitting Services
IMPACTED PLANS: Medicaid, HIV-SNP (Partnership in Care), and HARP (Health and Recovery Plans)
TO: All Vision Care Providers
This is a reminder of the New York State Medicaid regulations for vision care billing and criteria including contact lens fitting and corneal lens reimbursement:
According to the NYS Medicaid Vision Care Procedure Codes Manual, billing for the fitting of contact lens and for corneal lenses should be done with the following CPT codes:
Contact Lens Service Codes (92310–92326):
92310 – Prescription of optical and physical characteristics of and fitting of contact lens, (including materials) with medical supervision of adaptation (for ocular pathology); corneal lens, both eyes, except for aphakia.
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| 92311- corneal lens for aphakia, one eye (LT or RT modifier valid) 92312- corneal lens for aphakia, both eyes 92313- corneoscleral lens (one or both eyes) (LT, RT modifiers valid) 92326- Replacement of contact lens (one or both eyes) (LT, RT modifiers valid) |
Please refer to the NYS Medicaid billing guidelines and codes in the published NYS Medicaid Vision Care Procedure Codes Manual for additional information. Thank you for your continued commitment to accurate and compliant billing practices.
If you have any questions regarding this memo, please contact MetroPlusHealth at: [email protected].
last updated: November 12, 2025