Wisconsin Medicaid rate for CPT 99204
ForwardHealth pays a median of $110.94 across its rate types for CPT 99204 in its August 2026 fee-for-service schedule: the 9th-lowest of 45 state Medicaid programs, at 83% of the $134.20 median.
- Non-facility rate
- $110.94
- Rank
- 37 of 45
- vs. state median
- 83%
- vs. WI Medicare
- 66%
What ForwardHealth publishes for 99204
9th-lowest of 45 · 83% of median
- Schedule
- August 2026
- In effect since
- Jan 1, 2024
$99.86 to $110.94 across 10 rate types
- Rate type FAP · Provider type 71, specialty 000 · Telehealth
- $110.94
- Rate type MED · 2 provider specialties · 24 places of service
- $110.94
- Rate type MED · 2 provider specialties · Telehealth
- $110.94
- Rate type OTH · 2 provider specialties
- $110.94
- Rate type OTH · 2 provider specialties · 18 places of service
- $110.94
- Rate type PT5 · 2 provider specialties · 24 places of service
- $110.94
- Rate type PT6 · 63 provider specialties · 24 places of service
- $110.94
- Rate type PT6 · 63 provider specialties · Telehealth
- $110.94
- Rate type PT1 · 2 provider specialties · 24 places of service
- $99.86
- Rate type PT1 · 2 provider specialties · Telehealth
- $99.86
8 rate types
- Rate type FAP · Provider type 71, specialty 000 · Under 19 · Telehealth · Payment adjustment and 48 more (AQ)
- $110.94
- Rate type FAP · Provider type 71, specialty 000 · Under 19 · Telehealth · Payment adjustment and 23 more (TJ)
- $110.94
- Rate type MED · 2 provider specialties · 19 places of service and 11 more (TH)
- $110.94
- Rate type MED · 2 provider specialties · 19 places of service · HPSA adjustment and 5 more (AQ + TH)
- $110.94
- Rate type PT1 · 7 provider specialties · 24 places of service and 24 more (AQ)
- $99.86
- Rate type PT1 · Provider type 10, specialty 100 · Under 19 · 24 places of service · Payment adjustment and 11 more (TJ)
- $99.86
- Rate type PT1 · Provider type 10, specialty 100 · 19 places of service and 3 more (TH)
- $99.86
- Rate type PT1 · Provider type 10, specialty 100 · 19 places of service · HPSA adjustment and 1 more (AQ + TH)
- $99.86
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. ForwardHealth Maximum Allowable Fee Schedule
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 Wisconsin is $168.35; ForwardHealth's rate is 66% of that. The national amount before geographic adjustment is $177.359.
See 99204 Medicare ratesSee Wisconsin's full schedule: all 7,754 codes, every published period, and commercial payer rates for 99204.
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