MedicaidBilling CodesLow impact
High Index Lenses
South Dakota Medicaid·SD · Optometry·Provider Communication
Effective date
Nov 1, 2024
We identified it
Jun 21, 2026
Summary
South Dakota Medicaid clarified billing requirements for high index lenses, which are covered for recipients with prescriptions of at least +/- 7.00 diopters. Providers must use specific CPT codes V2782 or V2783 and document prescription strength in box 19 of CMS 1500, but should not use modifier 22 with other procedure codes.
Action Required
Immediately: Optometry and optical supply providers in South Dakota must ensure billing system uses CPT codes V2782 or V2783 for high index lenses (not modifier 22 with other codes). Document prescription strength in box 19 of CMS 1500 or submit copy of prescription with claims. Only bill for recipients with +/- 7.00 diopters or greater.