Based on public Medicaid payment data.

Average Medicaid Office Visit Payments in Ephrata, PA: $39.20

Avg. Paid

$39.20

Range

$0.00 – $180.97

Total Claims

74,582

Providers

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 Ephrata, PA

Provider	Avg. Paid	Claims	Patients
Laura R Vedder 136 Lake St	$38.23	12	12
Carlos Donayre 804 Grandview Dr Ste 2	$41.46	12	12
Monica F Johnson-Null 808 Pleasantview Dr	$128.48	12	12
Keith Bumeder 207 W Fulton St	$26.16	13	12
Govindbhai Parshottambhai Kachhadiya 169 Martin Ave	$41.95	20	20
Traci M Kohl 446 N Reading Rd	$65.00	25	24
William D Loretan 446 N Reading Rd	$46.76	26	24
Jillian Parsons 136 Lake Street	$180.97	32	30
John T Joseph 446 N Reading Rd	$44.43	32	30
Lauren Arrick 446 N Reading Rd	$61.17	35	35
Joy S Yoder 175 Martin Ave	$75.82	36	26
Alan Berkowitz 169 Martin Ave	$43.84	40	38
Karen Ann Crouse 175 Martin Ave	$70.97	41	38
David A Bigatel 175 Martin Ave	$32.21	42	26
Emily J Mccray 175 Martin Ave	$31.12	46	42
Kristen Reeser 101 Larkspur Ln	$27.25	48	41
Xanthi Kelly 446 N Reading Rd	$68.99	49	49
Ammar Alimam 446 N Reading Rd	$92.99	50	49
Wellspan Medical Group 808 Pleasantview Dr	$67.18	54	51
Samuel E Stoltzfus 446 N Reading Rd	$0.00	56	56
Jeffrey Newswanger 446 N Reading Rd	$1.14	59	56
Tina Marie Waters 446 N Reading Rd	$48.92	72	63
Jane E. Hearren 175 Martin Ave	$53.13	78	68
Alyssa Moran Winn 175 Martin Ave Ste 125	$60.12	101	90
Beth Irene Esterbrook 446 N Reading Rd	$49.44	129	121
Jose Luis Mejia Aguirre 804 Grandview Dr Ste 2	$48.20	132	117
Adam Batog 169 Martin Ave	$3.38	145	144
Sawsan Yasen Zammam 169 Martin Ave	$50.86	160	153
Monodeep Biswas 169 Martin Ave	$36.92	162	152
Vanessa Ann Pabon 446 N Reading Rd	$0.00	164	161
Erica Diaz 446 N Reading Rd Ste 302	$37.95	168	150
Lucinda Grace Manges 175 Martin Ave	$57.88	175	157
Jonathan H Griner 175 Martin Ave	$54.00	190	182
Darshan Lal 460 N Reading Rd	$50.16	192	167
Dirk Strasser 175 Martin Ave Ste 125	$41.92	198	181
Kristine M Leaman 175 Martin Ave Ste 125	$44.07	205	198
Eugene Edward Shuman 446 N Reading Rd	$0.00	224	218
Eliyahu E Fuchs 175 Martin Avenue	$39.69	242	228
Shirani David Rajan 207 W Fulton St	$69.65	247	233
Il Jun Chon 446 N Reading Rd	$64.43	248	227
Bandhu Paudyal 207 W Fulton St	$50.75	279	276
Wellspan Medical Group 446 N Reading Rd	$47.89	285	236
Ashley Anne Kempsell 1635 W Main St	$48.53	292	282
Lancaster General Medical Group 895 East Main Street	$70.43	297	281
James E Stephenson 4131A Oregon Pike	$50.25	327	314
Carl Richard Hankel 4237 Oregon Pike	$52.22	357	349
Michael Paul Delacruz 446 N Reading Rd	$25.73	392	348
John Carini 175 Martin Ave	$28.77	392	362
Shivani Bista 175 Martin Ave Ste 125	$59.36	397	382
Julia A Stern 175 Martin Ave	$42.56	410	397

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 Ephrata, PA?

Based on public Medicaid payment data, the average Medicaid reimbursement for Office Visit in Ephrata, PA is $39.20 per claim, based on 74,582 claims from 87 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 Ephrata, PA?

There are 87 Medicaid providers offering Office Visit related services in Ephrata, PA according to public payment data.

What is the price range for Office Visit in Ephrata, PA?

Medicaid reimbursement for Office Visit in Ephrata, PA ranges from $0.00 to $180.97 per claim, with an average of $39.20. Private insurance and self-pay costs are typically higher than these Medicaid rates.

Average Medicaid Office Visit Payments in Ephrata, PA: $39.20

Providers Offering Office Visit in Ephrata, PA

What to Expect: Office Visit

Cost Components

Frequently Asked Questions

Office Visit in Other Cities

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Other Procedures in Ephrata, PA

Emergency Room Visit

Physical Therapy

Blood Work & Lab Tests

X-Ray

Speech Therapy

Home Health Visit

Durable Medical Equipment (DME)

EKG / ECG (Electrocardiogram)