Pennsylvania Medicaid rate for CPT 99203
Pennsylvania Medical Assistance pays $54.25 for CPT 99203 in its October 2026 fee-for-service schedule: the 2nd-lowest of 45 state Medicaid programs, at 61% of the $89.35 median.
- Non-facility rate
- $54.25
- Rank
- 44 of 45
- vs. state median
- 61%
- vs. PA Medicare
- 44-48%
What Pennsylvania Medical Assistance publishes for 99203
2nd-lowest of 45 · 61% of median
- Schedule
- October 2026
- In effect since
- Feb 17, 2025
3 rate types
- Telehealth and 4 more (FP)
- $54.25
- Telehealth and 3 more (TH)
- $54.25
- Telehealth and 4 more (U9)
- $54.25
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. DHS Outpatient Fee Schedule
99203 in neighboring states
Each state's comparable non-facility rate for 99203 in its current schedule.
| State | Rate | vs. Pennsylvania |
|---|---|---|
| Delaware | $114.26 | +111% |
| Maryland | $116.38 | +115% |
| New Jersey | $84.64 | +56% |
| Ohio | $61.22 | +13% |
| West Virginia | $81.25 | +50% |
99203 in every state
Map and ranking of every state program that prices 99203.
Compare 99203 across states99203 under Medicare
Medicare's 2026 non-facility payment for 99203 in Pennsylvania is $112.46 to $121.97 across its 2 payment localities; Pennsylvania Medical Assistance's rate is 44-48% of that. The national amount before geographic adjustment is $117.571.
See 99203 Medicare ratesSee Pennsylvania's full schedule: all 6,593 codes, every published period, and commercial payer rates for 99203.
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