Average Medicaid Office Visit Payments in Berwick, PA: $34.52
Avg. Paid
$34.52
Range
$21.16 – $63.95
Total Claims
46,924
Providers
15
Typical Payment Range
Typical Medicaid Office Visit payments fall between $29.28 and $67.92 per claim (median: $46.55). The top 10% of payments exceed $95.29.
Based on per-provider averages across all Medicaid claims in this category.
A standard doctor's office visit for evaluation and management of medical conditions. Includes new patient visits, follow-up visits, and consultations.
Understanding these costs
The amounts shown are Medicaid reimbursement rates — what state Medicaid programs paid providers per claim. Medicaid typically pays well below private insurance rates and out-of-pocket prices. Use this data to compare relative costs between providers, not as a price estimate for privately insured or self-pay patients.
Providers Offering Office Visit in Berwick, PA
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Moin U Mallhi
1200 Freas Ave |
$26.79 | 17,118 | 15,088 |
|
Albert J Alley
301 West Third Street |
$33.13 | 9,682 | 8,836 |
|
Michael R. Ashton
2200 W Front St |
$39.42 | 8,528 | 8,223 |
|
Marvin Scott Hurley
2200 W Front St |
$41.83 | 4,281 | 4,136 |
|
Tamer Mohamed Fathy
2200 W Front St |
$51.81 | 2,717 | 2,584 |
|
Grace Guerrier
2200 W Front St |
$50.53 | 2,296 | 2,213 |
|
Alva D Smith
751 E 16Th St |
$22.89 | 881 | 853 |
|
Michelle Lynn Hall
695 E 16Th St Ste B |
$22.26 | 553 | 386 |
|
Howard Duryea
65 Briar Creek Plz |
$44.82 | 353 | 346 |
|
Verona D Roberts
1918 W Front St |
$36.34 | 177 | 170 |
|
Jason Scotti
695 E 16Th St Ste B |
$38.70 | 176 | 163 |
|
Robert Dougherty
126 W Front St |
$63.95 | 71 | 71 |
|
John Anthony Guerriero
1918 W Front St |
$21.16 | 66 | 65 |
|
Berwick Clinic Company Llc
751 E 16Th St |
$36.71 | 13 | 12 |
|
Pavel Pribula
751 E 16Th St |
$40.81 | 12 | 12 |
What to Expect: Office Visit
A typical office visit lasts 15-45 minutes depending on complexity. Your doctor will review your medical history, discuss symptoms, perform a physical exam, and discuss treatment options. You may receive prescriptions, referrals, or orders for diagnostic tests. Follow-up visits are usually shorter than new patient visits.
Cost Components
National average Medicaid payment per billing code. Individual rates vary by provider and state.
| Code | Description | Avg. Paid | Claims | Providers |
|---|---|---|---|---|
| 99213 | Office visit established mod | $43.18 | 764,306,590 | 487,602 |
| 99214 | Office visit established mod-hi | $59.53 | 502,480,931 | 466,856 |
| 99212 | Office visit established low | $41.69 | 92,299,154 | 127,462 |
| 99203 | Office visit new moderate | $67.55 | 47,756,882 | 127,334 |
| 99211 | Office visit established minor | $39.24 | 44,127,221 | 47,748 |
| 99204 | Office visit new moderate-high | $92.03 | 32,379,031 | 111,937 |
| 99215 | Office visit established high | $93.58 | 29,619,773 | 74,725 |
| 99202 | Office visit new low | $58.57 | 9,372,712 | 35,486 |
| 99205 | Office visit new high | $136.10 | 3,665,382 | 19,737 |
| 99244 | Office consultation mod-high | $118.25 | 3,405,681 | 11,884 |
| 99243 | Office consultation moderate | $78.55 | 2,585,480 | 8,432 |
| 99245 | Office consultation high | $132.29 | 645,300 | 3,046 |
| 99242 | Office consultation low | $58.27 | 483,445 | 1,980 |
| 99241 | Office consultation brief | $66.15 | 295,664 | 712 |
These are national Medicaid averages for each billing code. Actual amounts vary by state, provider, and complexity.
Frequently Asked Questions
How much does a Office Visit cost in Berwick, PA?
Based on public Medicaid payment data, the average Medicaid reimbursement for Office Visit in Berwick, PA is $34.52 per claim, based on 46,924 claims from 15 providers. Typical payments fall between $29.28 and $67.92. Note: Medicaid rates are typically much lower than private insurance or self-pay prices.
How many providers offer Office Visit in Berwick, PA?
There are 15 Medicaid providers offering Office Visit related services in Berwick, PA according to public payment data.
What is the price range for Office Visit in Berwick, PA?
Medicaid reimbursement for Office Visit in Berwick, PA ranges from $21.16 to $63.95 per claim, with an average of $34.52. Private insurance and self-pay costs are typically higher than these Medicaid rates.
Office Visit in Other Cities
Brooklyn, NY
Avg $71.20
32,336,840 claims · 5588 providers
New York, NY
Avg $81.86
23,551,154 claims · 7530 providers
Los Angeles, CA
Avg $24.20
16,948,065 claims · 5565 providers
Chicago, IL
Avg $30.31
13,989,780 claims · 5801 providers
Bronx, NY
Avg $82.40
13,626,712 claims · 3705 providers
Phoenix, AZ
Avg $47.53
13,269,420 claims · 4233 providers
Houston, TX
Avg $48.27
8,766,644 claims · 4540 providers
Las Vegas, NV
Avg $54.47
8,578,324 claims · 3512 providers
Other Procedures in Berwick, PA
Physical Therapy
Avg $18.12
16,872 claims
Speech Therapy
Avg $4.00
16,686 claims
Dental Cleaning & Exam
Avg $26.74
10,927 claims
Blood Work & Lab Tests
Avg $9.00
9,501 claims
Ambulance Transport
Avg $22.83
8,392 claims
Eye Exam
Avg $26.85
7,673 claims
EKG / ECG (Electrocardiogram)
Avg $6.24
4,933 claims
Home Health Visit
Avg $47.26
3,895 claims