Maryland Medicaid rate for CPT 99204
Maryland Medicaid pays $174.01 for CPT 99204 in its September 2026 fee-for-service schedule: the 9th-highest of 45 state Medicaid programs, at 130% of the $134.20 median.
- Non-facility rate
- $174.01
- Rank
- 9 of 45
- vs. state median
- 130%
- vs. MD Medicare
- 88-97%
What Maryland Medicaid publishes for 99204
9th-highest of 45 · 130% of median
- Schedule
- September 2026
- Prior authorization
- Not required
$174.01 to $178.20 across 2 rate types
- PCP
- $178.20
- General
- $174.01
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. MDH Professional Services Fee Schedule
99204 in neighboring states
Each state's comparable non-facility rate for 99204 in its current schedule.
| State | Rate | vs. Maryland |
|---|---|---|
| Delaware | $172.47 | -1% |
| Pennsylvania | $90.37 | -48% |
| Virginia | $127.86 | -27% |
| West Virginia | $122.98 | -29% |
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 Maryland is $178.56 to $197.64 across its 3 payment localities; Maryland Medicaid's rate is 88-97% of that. The national amount before geographic adjustment is $177.359.
See 99204 Medicare ratesSee Maryland's full schedule: all 8,533 codes, every published period, and commercial payer rates for 99204.
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