Average Medicaid Office Visit Payments in Downingtown, PA: $57.39
Avg. Paid
$57.39
Range
$2.19 – $111.80
Total Claims
47,399
Providers
24
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 Downingtown, PA
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Elizabeth M Facciolo
142 Wallace Ave Ste 201 |
$32.08 | 12 | 12 |
|
Shannon Kimberly Lieb
967 E Lancaster Ave |
$2.19 | 16 | 14 |
|
Laurie A Gallagher
142 Wallace Ave Ste 201 |
$58.74 | 19 | 17 |
|
Eugene J Ferguson
150 E Pennsylvania Ave Ste 200 |
$38.36 | 40 | 38 |
|
Kathryn Elizabeth Italia
1318 New Virginia Rd |
$30.34 | 60 | 56 |
|
Fraulein Fangfei Li
150 E Pennsylvania Ave Ste 250 |
$19.47 | 73 | 72 |
|
Eric Dicicco
142 Wallace Ave Ste 201 |
$40.39 | 74 | 66 |
|
Ogochukwu Nefertiti Nwaobasi
1229 Horseshoe Pike |
$9.76 | 112 | 99 |
|
John N Riccardo
363 E Lancaster Ave |
$7.84 | 131 | 93 |
|
Rannette C Schurtz
142 Wallace Ave Ste 201 |
$48.42 | 133 | 129 |
|
Leonard Charles Giunta
797 E Lancaster Ave |
$6.28 | 143 | 108 |
|
Jessica Schleusner
142 Wallace Ave Ste 201 |
$45.39 | 169 | 160 |
|
Vitasta Bamezai
142 Wallace Ave Ste 201 |
$39.42 | 174 | 170 |
|
Juliet Cook
150 E Pennsylvania Ave Ste 200 |
$9.77 | 175 | 170 |
|
Gayle Elizabeth Redditt
150 E Pennsylvania Ave Ste 140 |
$38.04 | 203 | 198 |
|
Ashley David
150 E Pennsylvania Ave Ste 250 |
$18.28 | 238 | 224 |
|
Victoria Brosius Kollar
142 Wallace Ave Ste 201 |
$41.18 | 1,010 | 949 |
|
Amy Schultz
1229 Horseshoe Pike |
$21.14 | 1,217 | 1,147 |
|
Edward A. Kelly
99 Manor Ave |
$32.93 | 1,523 | 1,370 |
|
Pennsylvania Urgent Care Centers, Pllc
150 E Pennsylvania Ave |
$39.81 | 1,901 | 1,653 |
|
Madhavi Cherukuri
150 E Pennsylvania Ave |
$44.86 | 2,680 | 2,596 |
|
Frances Koblenzer
410 Boot Rd |
$111.80 | 4,568 | 4,060 |
|
Lawrence K Alwine
77 Manor Ave |
$48.99 | 6,824 | 6,390 |
|
David J Cooper
1244 Cornerstone Boulevard |
$58.47 | 25,904 | 23,582 |
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 Downingtown, PA?
Based on public Medicaid payment data, the average Medicaid reimbursement for Office Visit in Downingtown, PA is $57.39 per claim, based on 47,399 claims from 24 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 Downingtown, PA?
There are 24 Medicaid providers offering Office Visit related services in Downingtown, PA according to public payment data.
What is the price range for Office Visit in Downingtown, PA?
Medicaid reimbursement for Office Visit in Downingtown, PA ranges from $2.19 to $111.80 per claim, with an average of $57.39. 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 Downingtown, PA
Speech Therapy
Avg $18.44
191,203 claims
Physical Therapy
Avg $15.61
170,447 claims
Home Health Visit
Avg $111.18
144,002 claims
Dental Cleaning & Exam
Avg $30.22
25,180 claims
Ambulance Transport
Avg $41.84
13,411 claims
Vaccines & Immunizations
Avg $11.18
12,579 claims
Hearing Test (Audiometry)
Avg $8.45
4,757 claims
Eye Exam
Avg $32.86
4,110 claims