Illinois Medicaid rate for CPT 99204
Illinois Medicaid pays $90.81 for CPT 99204 in its July 2026 fee-for-service schedule: the 4th-lowest of 45 state Medicaid programs, at 68% of the $134.20 median.
- Non-facility rate
- $90.81
- Rank
- 42 of 45
- vs. state median
- 68%
- vs. IL Medicare
- 48-52%
What Illinois Medicaid publishes for 99204
4th-lowest of 45 · 68% of median
- Schedule
- July 2026
- In effect since
- Apr 1, 2024
- Prior authorization
- Not published
1 rate type
- Prenatal Subsequent (U5)
- $104.96
Unmodified non-facility fee-for-service rate from the state's published file. Managed-care contracts, supplemental payments, and claim-specific adjustments can change what is paid. HFS Practitioner Fee Schedule
99204 in neighboring states
Each state's comparable non-facility rate for 99204 in its current schedule.
99204 in every state
Map and ranking of every state program that prices 99204.
Compare 99204 across states99204 under Medicare
Medicare's 2026 non-facility payment for 99204 in Illinois is $174.69 to $188.76 across its 4 payment localities; Illinois Medicaid's rate is 48-52% of that. The national amount before geographic adjustment is $177.359.
See 99204 Medicare ratesSee Illinois's full schedule: all 9,319 codes, every published period, and commercial payer rates for 99204.
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