Ohio Medicaid rate for CPT 99204
Ohio Medicaid pays $93.36 for CPT 99204 in its January 2026 fee-for-service schedule: the 5th-lowest of 45 state Medicaid programs, at 70% of the $134.20 median.
- Non-facility rate
- $93.36
- Rank
- 41 of 45
- vs. state median
- 70%
- vs. OH Medicare
- 55%
What Ohio Medicaid publishes for 99204
5th-lowest of 45 · 70% of median
- Schedule
- January 2026
- In effect since
- Jan 1, 2024
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. Ohio Medicaid Schedules & Rates
99204 in neighboring states
Each state's comparable non-facility rate for 99204 in its current schedule.
| State | Rate | vs. Ohio |
|---|---|---|
| Indiana | $153.78 | +65% |
| Kentucky | $112.27 | +20% |
| Michigan | $113.10 | +21% |
| Pennsylvania | $90.37 | -3% |
| West Virginia | $122.98 | +32% |
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 Ohio is $170.25; Ohio Medicaid's rate is 55% of that. The national amount before geographic adjustment is $177.359.
See 99204 Medicare ratesSee Ohio's full schedule: all 7,309 codes, every published period, and commercial payer rates for 99204.
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