Maryland Medicaid Fee Schedule
Maryland Medicaid pays $94.62 on its ordinary schedule for an established-patient office visit (99213), and $94.62 to $97.02 across its rate types. The ordinary rate is the 8th-highest of 45 Medicaid programs.
- Schedule as of
- September 2026
- Codes priced
- 8,533
- 99213 vs. median
- 133% of median
Current Maryland Medicaid rates for common codes
Each amount is the unmodified non-facility rate in the September 2026 schedule. Where a code appears under more than one rate type, it is the state's ordinary statewide rate when its rules name one, and otherwise the median across rate types. Modifier-specific and facility-only rows are listed separately under the service.
| Code | Service | Non-facility rate | Prior auth |
|---|---|---|---|
| 99213 | Office visit, established patient (low complexity)$94.62 to $97.02 across 2 rate types
| $94.62Ordinary statewide rate8th-highest of 45 · 133% of median | Not required |
| 99214 | Office visit, established patient (moderate complexity)$133.26 to $136.43 across 2 rate types
| $133.26Ordinary statewide rate8th-highest of 45 · 132% of median | Not required |
| 99203 | Office visit, new patient (low complexity)$116.38 to $119.17 across 2 rate types
| $116.38Ordinary statewide rate9th-highest of 45 · 130% of median | Not required |
| 99204 | Office visit, new patient (moderate complexity)$174.01 to $178.20 across 2 rate types
| $174.01Ordinary statewide rate9th-highest of 45 · 130% of median | Not required |
| 99285 | Emergency department visit, high severity with threat to function2 rate types
| See rate choices |
Dot: Maryland. Tick: median across state programs. Line: lowest to highest state. Base fee-for-service rates; supplemental payments some states add are not included.
Maryland is 8th-highest of 45 for 99213. See where all 8,533 Maryland Medicaid codes rank.
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Compare any other code across state programs. The free view shows a few states per code; Maryland's full schedule is in the complete dataset.
Neighboring and high-enrollment Medicaid fee schedules
States bordering Maryland first, then the largest programs.