What does Bcbs Al pay for CPT 99204 in Huntsville, AL?

The local peer median for CPT 99204 under Bcbs Al in Huntsville, AL is $111.25, based on 500 indexed providers. Modeled from published rates, not guaranteed.

What is the top of the local market (P90) for CPT 99204 under Bcbs Al in Huntsville, AL?

The P90, the top of the local market and Reddenda's target rate, is $134.11.

How does Bcbs Al's rate for CPT 99204 compare to Medicare?

The Bcbs Al local median of $111.25 is 63% of Medicare's national non-facility rate of $177.36 for CPT 99204.

Reddenda · Rate Intelligence · Huntsville, AL

99204 under Bcbs Al in Huntsville, AL

Name: Bcbs Al rates for CPT 99204 in Huntsville, AL
Creator: Reddenda

Office visit, new patient, 45-59 min · Local peer median $111.25 · High confidence

$111.25 local peer median. In the Huntsville, AL market, Bcbs Al pays a local peer median of $111.25 for CPT 99204 (Office visit, new patient, 45-59 min), based on 500 providers in Reddenda's index of Bcbs Al's own published in-network rates. The top of the local market, the P90 target, is $134.11, 21% above the median. A provider billed below the local median is being paid less than peers holding the identical Bcbs Al contract in Huntsville, AL for the identical code. Modeled from published rates, not guaranteed.

Local distribution · 500 providers · 500 rate records

P10

$81.21

P25

$111.25

Median

$111.25

P75

$122.38

P90 (target)

$134.11

P10$81.21

P25$111.25

Median (P50)$111.25

P75$122.38

P90 target$134.11

Peer basis: local peer distribution: same CPT, same payer file, same metro (CBSA) Benchmark: local peer median; never a national average Range: $81.21 – $168.16

The local peer median for CPT 99204 under Bcbs Al in Huntsville, AL is $111.25, drawn from 500 distinct providers.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Bcbs Al to publish this rate
The bottom of the local market (P10) is $81.21 and the top (P90) is $134.11; the median-to-P90 spread is $22.86.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Bcbs Al to publish this rate
The lowest published rate in this market is $81.21; the highest is $168.16.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Bcbs Al to publish this rate
This benchmark is drawn from 500 individual rate records that Bcbs Al itself published for this code in this metro.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Bcbs Al to publish this rate
Medicare's national non-facility rate for CPT 99204 is $177.36, making the Bcbs Al local median 63% of Medicare.Source: Medicare Physician Fee Schedule; the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Bcbs Al to publish this rate
36% of indexed providers cluster at the single most common rate; the remainder shows a real, scoreable spread across the local market.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Bcbs Al to publish this rate
A federal No Surprises Act arbitrator may weigh up to four plan years of a provider's own contracted rate history and local market share when resolving a payment dispute over this exact code and payer.Source: 45 CFR §149.510(c)(4)(iii)(B)

500 providers bill this code to this payer in this metro.

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This is the local market for CPT 99204 (Office visit, new patient, 45-59 min) under Bcbs Al in Huntsville, AL. Enter your NPI to see your own contracted rate against this peer curve, per payer and per code. Free, about 15 seconds, no card and no PHI.

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Documented reimbursement opportunity, modeled from published rates and never a guaranteed outcome.

Modeled from Bcbs Al's own published in-network rates, never guaranteed and never a national average. Peer basis: same CPT, same payer file, same metro (CBSA). Federal citation for the underlying obligation: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Bcbs Al to publish this rate. Page generated 2026-08-23 23:56 UTC; the live index is queried in real time on every request.