Pennsylvania Medicaid rate for CPT 99285
Pennsylvania Medical Assistance pays $138.74 for CPT 99285 in its October 2026 fee-for-service schedule: the 21st-highest of 42 state Medicaid programs, at 100% of the $138.69 median.
- Non-facility rate
- $138.74
- Rank
- 21 of 42
- vs. state median
- 100%
- vs. PA Medicare
- 78-82%
What Pennsylvania Medical Assistance publishes for 99285
21st-highest of 42 · 100% of median
- Schedule
- October 2026
- In effect since
- Sep 1, 2021
1 rate type
- Telehealth and 1 more (TH)
- $138.74
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
99285 in neighboring states
Each state's comparable non-facility rate for 99285 in its current schedule.
| State | Rate | vs. Pennsylvania |
|---|---|---|
| Delaware | $166.73 | +20% |
| New Jersey | $119.36 | -14% |
| Ohio | $94.23 | -32% |
| West Virginia | $126.15 | -9% |
99285 in every state
Map and ranking of every state program that prices 99285.
Compare 99285 across states99285 under Medicare
Medicare's 2026 non-facility payment for 99285 in Pennsylvania is $168.68 to $177.74 across its 2 payment localities; Pennsylvania Medical Assistance's rate is 78-82% of that. The national amount before geographic adjustment is $171.347.
See 99285 Medicare ratesSee Pennsylvania's full schedule: all 6,593 codes, every published period, and commercial payer rates for 99285.
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