Washington Medicaid rate for CPT 99204
Apple Health pays a median of $98.53 across its rate types for CPT 99204 in its October 2026 fee-for-service schedule: the 7th-lowest of 45 state Medicaid programs, at 73% of the $134.20 median.
- Non-facility rate
- $98.53
- Rank
- 39 of 45
- vs. state median
- 73%
- vs. WA Medicare
- 50-54%
What Apple Health publishes for 99204
7th-lowest of 45 · 73% of median
- Schedule
- October 2026
- Prior authorization
- Conditional
$79.07 to $117.99 across 2 rate types
- Under 21
- $117.99
- Ages 21+
- $79.07
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. HCA Provider Billing Guides & Fee Schedules
99204 in neighboring states
Each state's comparable non-facility rate for 99204 in its current schedule.
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 Washington is $180.94 to $198.96 across its 2 payment localities; Apple Health's rate is 50-54% of that. The national amount before geographic adjustment is $177.359.
See 99204 Medicare ratesSee Washington's full schedule: all 8,727 codes, every published period, and commercial payer rates for 99204.
Book a 15-min Medicaid walkthrough