Maryland Medicaid rate for CPT 99213
Maryland Medicaid pays $94.62 for CPT 99213 in its September 2026 fee-for-service schedule: the 8th-highest of 45 state Medicaid programs, at 133% of the $71.05 median.
- Non-facility rate
- $94.62
- Rank
- 8 of 45
- vs. state median
- 133%
- vs. MD Medicare
- 89-99%
What Maryland Medicaid publishes for 99213
8th-highest of 45 · 133% of median
- Schedule
- September 2026
- Prior authorization
- Not required
$94.62 to $97.02 across 2 rate types
- PCP
- $97.02
- General
- $94.62
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
99213 in neighboring states
Each state's comparable non-facility rate for 99213 in its current schedule.
| State | Rate | vs. Maryland |
|---|---|---|
| Delaware | $92.63 | -2% |
| Pennsylvania | $35.00 | -63% |
| Virginia | $68.63 | -27% |
| West Virginia | $65.15 | -31% |
99213 in every state
Map and ranking of every state program that prices 99213.
Compare 99213 across states99213 under Medicare
Medicare's 2026 non-facility payment for 99213 in Maryland is $95.97 to $106.56 across its 3 payment localities; Maryland Medicaid's rate is 89-99% of that. The national amount before geographic adjustment is $95.193.
See 99213 Medicare ratesSee Maryland's full schedule: all 8,533 codes, every published period, and commercial payer rates for 99213.
Book a 15-min Medicaid walkthrough