Average Medicaid Office Visit Payments in Cumberland, KY: $32.09
Avg. Paid
$32.09
Range
$12.95 – $49.74
Total Claims
98,467
Providers
10
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 Cumberland, KY
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Christopher Lewis
103 Kingdom Come Dr |
$31.31 | 22,508 | 17,769 |
|
Tracey Nycole Blakley
1620 E Main St |
$35.08 | 21,214 | 16,383 |
|
Melissa C Burns
103 Kingdom Come Dr |
$29.58 | 17,695 | 13,985 |
|
Christa Leigh Addington
1620 E Main St |
$49.74 | 10,894 | 9,616 |
|
Pamela Sherman-Sheffield
18880 N Us Highway 119 |
$26.73 | 7,457 | 5,700 |
|
Brianna D Cornett
900 E Main St |
$25.40 | 6,376 | 3,481 |
|
Billie Jo Jackson
18880 N Us Highway 119 |
$28.92 | 5,852 | 4,979 |
|
Appalachian Regional Healthcare, Inc.
18880 N Us Highway 119 |
$16.15 | 2,689 | 1,402 |
|
Melissa Kay Witt
18880 Us Highway 119 |
$22.99 | 2,289 | 1,500 |
|
Quantum Healthcare Associates Of Cumberland, Inc
103 Kingdom Come Dr |
$12.95 | 1,493 | 966 |
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 Cumberland, KY?
Based on public Medicaid payment data, the average Medicaid reimbursement for Office Visit in Cumberland, KY is $32.09 per claim, based on 98,467 claims from 10 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 Cumberland, KY?
There are 10 Medicaid providers offering Office Visit related services in Cumberland, KY according to public payment data.
What is the price range for Office Visit in Cumberland, KY?
Medicaid reimbursement for Office Visit in Cumberland, KY ranges from $12.95 to $49.74 per claim, with an average of $32.09. 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 Cumberland, KY
Blood Work & Lab Tests
Avg $7.54
9,655 claims
Prescription Medications
Avg $4.79
4,571 claims
Urinalysis & Urine Tests
Avg $3.90
2,603 claims
Wound Care
Avg $17.97
1,198 claims
Vaccines & Immunizations
Avg $11.90
745 claims
Emergency Room Visit
Avg $52.30
466 claims
EKG / ECG (Electrocardiogram)
Avg $5.17
112 claims
X-Ray
Avg $11.46
51 claims