Rhode Island Medicaid rate for CPT 99204
Rhode Island Medicaid pays $180.87 for CPT 99204 in its October 2026 fee-for-service schedule: the 8th-highest of 45 state Medicaid programs, at 135% of the $134.20 median.
- Non-facility rate
- $180.87
- Rank
- 8 of 45
- vs. state median
- 135%
- vs. RI Medicare
- 100%
What Rhode Island Medicaid publishes for 99204
8th-highest of 45 · 135% of median
- Schedule
- October 2026
- In effect since
- Jul 1, 2026
5 rate types
- Level 3 · PAC I · Up to 1 unit (25)
- $180.87
- Level 3 · PAC I · Up to 1 unit (GA)
- $180.87
- Level 3 · PAC I · Up to 1 unit (GE)
- $180.87
- Level 3 · PAC I · Up to 1 unit (GT)
- $180.87
- Level 4 · PAC S · Up to 1 unit (U8)
- $153.74
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. EOHHS Fee Schedules
99204 in neighboring states
Each state's comparable non-facility rate for 99204 in its current schedule.
| State | Rate | vs. Rhode Island |
|---|---|---|
| Connecticut | $116.98 | -35% |
| Massachusetts | $128.18 | -29% |
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 Rhode Island is $180.87; Rhode Island Medicaid's rate is 100% of that. The national amount before geographic adjustment is $177.359.
See 99204 Medicare ratesSee Rhode Island's full schedule: all 12,354 codes, every published period, and commercial payer rates for 99204.
Book a 15-min Medicaid walkthrough