Summary & Overview
HCPCS V2100: Single-Vision Spherical Lens, Plano to ±4.00
HCPCS Level II code V2100 denotes a single-vision spherical lens provided per lens, with a power range from plano to ±4.00 diopters. This supply code is used when a standard corrective lens meeting those spherical specifications is furnished to a patient and is relevant across vision benefit programs and medical plans that cover corrective lenses. The code matters nationally because it standardizes reporting for a common optical supply used in routine refractive correction and influences coverage, prior authorization, and billing practices across major payers.
Key payers considered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of payer coverage patterns, typical sites of service, and clinical context for when a single-vision spherical lens in this power range is appropriate. The publication provides benchmarks for utilization and reimbursement structures where available, summarizes relevant policy considerations affecting coverage of optical supplies, and explains the clinical scenario tied to this code. Data limitations or unavailable items from the input are noted where applicable. The content is intended for a national audience of billing managers, policy analysts, and clinical administrators seeking concise guidance on coding and administrative context for HCPCS Level II code V2100.
Billing Code Overview
HCPCS Level II code V2100 describes a single vision spherical lens provided per lens, with power ranging from plano to ±4.00 diopters. This code covers the supply of a standard single-vision corrective lens intended to correct refractive error within the specified spherical power range.
Service type: Eyewear supply — single-vision corrective lens
Typical site of service: Optical dispensary, ophthalmology clinic, optometry office, or retail optical outlet
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 45-year-old patient presents to an optometry clinic for routine refractive correction. After manifest refraction and visual acuity testing, the clinician determines the patient requires single-vision spectacle lenses with no spherical power (plano) to correct mild astigmatism or to provide plano reading lenses. The service corresponds to fabrication and dispensing of a single-vision spherical lens within the range plano to ±4.00 diopters per lens, billed under V2100. Typical workflow: patient registration and insurance verification; clinical refraction by an optometrist or ophthalmologist; lens selection and measurements (vertex distance, pupillary distance) by the dispensing technician; order entry to a optical lab or in-office lens finishing; verification and fitting appointment for frame mounting and patient education. Typical site of service is an outpatient optometry or ophthalmology clinic or an optical dispensary within a multispecialty ambulatory facility.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the professional component of eye care services provided separately from materials. |
50 |