West Virginia Medicaid rate for CPT 99204
West Virginia Medicaid pays $122.98 for CPT 99204 in its April 2026 fee-for-service schedule: the 17th-lowest of 45 state Medicaid programs, at 92% of the $134.20 median.
- Non-facility rate
- $122.98
- Rank
- 29 of 45
- vs. state median
- 92%
- vs. WV Medicare
- 72%
What West Virginia Medicaid publishes for 99204
17th-lowest of 45 · 92% of median
- Schedule
- April 2026
- In effect since
- Apr 1, 2026
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. BMS Physician RBRVS Fee Schedules
99204 in neighboring states
Each state's comparable non-facility rate for 99204 in its current schedule.
| State | Rate | vs. West Virginia |
|---|---|---|
| Kentucky | $112.27 | -9% |
| Maryland | $174.01 | +41% |
| Ohio | $93.36 | -24% |
| Pennsylvania | $90.37 | -27% |
| Virginia | $127.86 | +4% |
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 West Virginia is $170.01; West Virginia Medicaid's rate is 72% of that. The national amount before geographic adjustment is $177.359.
See 99204 Medicare ratesSee West Virginia's full schedule: all 7,002 codes, every published period, and commercial payer rates for 99204.
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