Pennsylvania Medicaid rate for CPT 99214
Pennsylvania Medical Assistance pays $54.42 for CPT 99214 in its October 2026 fee-for-service schedule: the 2nd-lowest of 45 state Medicaid programs, at 54% of the $101.32 median.
- Non-facility rate
- $54.42
- Rank
- 44 of 45
- vs. state median
- 54%
- vs. PA Medicare
- 39-42%
What Pennsylvania Medical Assistance publishes for 99214
2nd-lowest of 45 · 54% of median
- Schedule
- October 2026
- In effect since
- Feb 17, 2025
4 rate types
- Telehealth and 4 more (FP)
- $54.42
- Telehealth and 3 more (TH)
- $54.42
- Telehealth and 3 more (U6)
- $54.42
- Office and 2 more (U9)
- $54.42
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
99214 in neighboring states
Each state's comparable non-facility rate for 99214 in its current schedule.
| State | Rate | vs. Pennsylvania |
|---|---|---|
| Delaware | $131.96 | +142% |
| Maryland | $133.26 | +145% |
| New Jersey | $97.55 | +79% |
| Ohio | $70.11 | +29% |
| West Virginia | $93.21 | +71% |
99214 in every state
Map and ranking of every state program that prices 99214.
Compare 99214 across states99214 under Medicare
Medicare's 2026 non-facility payment for 99214 in Pennsylvania is $129.87 to $140.40 across its 2 payment localities; Pennsylvania Medical Assistance's rate is 39-42% of that. The national amount before geographic adjustment is $135.608.
See 99214 Medicare ratesSee Pennsylvania's full schedule: all 6,593 codes, every published period, and commercial payer rates for 99214.
Book a 15-min Medicaid walkthrough