Medicare Physician Fee Schedule · Q3 2026 release
CPT 99214 in Baltimore, MD
A more involved established-patient visit — for example, managing multiple chronic conditions that are not fully controlled (such as diabetes needing a medication change), or a new problem with an uncertain diagnosis that requires prescription drug management. Total visit time typically runs about 30 to 39 minutes. Documentation needs to support a higher level of decision-making: more than one chronic illness with exacerbation, or moderate risk from the treatment plan, such as starting or adjusting a prescription drug.
Medicare pays, Office (non-facility) setting, in Baltimore, MD
$142.62
Before the ~2% sequestration cut. Q3 2026 Physician Fee Schedule.
Local vs. national amount
Baltimore, MD pays above the national baseline by 5.2%, driven by this locality's GPCIs.
Facility setting
In a facility (e.g. hospital outpatient), Baltimore, MD pays $87.78 for 99214.
ZIP codes in this locality
This payment locality covers 202 ZIP codes, including 20588, 20701, 20711, 20723, 20724, 20733, 20751, 20755, 20758, 20759, 20763, 20764 and others . Every ZIP in this locality is priced the same under the Physician Fee Schedule.