Average Medicaid Office Visit Payments in Gloucester, MA: $41.95
Avg. Paid
$41.95
Range
$0.00 – $80.44
Total Claims
88,661
Providers
30
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 Gloucester, MA
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Nathan Spencer
321 Washington St |
$21.79 | 20 | 20 |
|
Meghan M Tupper
302 Washington St |
$10.98 | 21 | 14 |
|
Emily Ann Doucette
302 Washington St |
$0.00 | 32 | 28 |
|
Stefanie Belcher
1 Blackburn Dr |
$2.57 | 56 | 54 |
|
Sarah Curran
298 Washington St |
$37.47 | 75 | 69 |
|
Matthew William Weinstein-Zanger
35 Middle St |
$23.94 | 84 | 84 |
|
Susan L Stefanski
298 Washington Street |
$21.79 | 92 | 90 |
|
Kara Leslie
305 Gloucester Crossing Road |
$62.93 | 107 | 102 |
|
Thomas Stephen Pearce
279 E Main St |
$57.85 | 117 | 104 |
|
Robert E Slocum
302 Washington Street Gloucester Family Health Center |
$45.40 | 214 | 181 |
|
Kim Graham
298 Washington St |
$26.75 | 330 | 310 |
|
Roderick J Anscombe
5 Main St |
$12.27 | 334 | 307 |
|
Beth Israel Lahey Health Specialty Care, Inc.
298 Washington St |
$32.60 | 421 | 381 |
|
Zaven E Jouhourian
298 Washington St |
$38.68 | 547 | 509 |
|
Kathryn Joan Hollett
Lahey Health Primary Care, Gloucester |
$34.55 | 619 | 573 |
|
Karen E Damico
298 Washington St |
$29.19 | 1,048 | 989 |
|
Amy Bonner Esdale
298 Washington St |
$44.56 | 1,379 | 1,281 |
|
Michael A Arsenian
298 Washington St. |
$33.61 | 1,539 | 1,511 |
|
Jay J Isaac
1 Blackburn Dr |
$41.85 | 1,955 | 1,655 |
|
Stephen Kulcsar
302 Washington St |
$80.44 | 2,188 | 2,114 |
|
Victor Carabba
298 Washington St |
$37.27 | 2,257 | 2,139 |
|
Thomas V Carbone
298 Washington St |
$63.63 | 2,814 | 2,518 |
|
Beth Israel Lahey Health Primary Care, Inc.
Lahey Health Urgent Care Gloucester |
$67.29 | 3,597 | 3,457 |
|
Jean A Anscombe
85 Eastern Ave Ste 302 |
$43.65 | 4,477 | 3,982 |
|
Neil D Kobrosky
298 Washington St |
$34.94 | 5,649 | 5,626 |
|
Janet E Doran
1 Blackburn Dr |
$33.81 | 6,295 | 5,714 |
|
James M Maguire
1 Blackburn Dr |
$29.22 | 8,976 | 8,066 |
|
Shawn R Pawson
1 Blackburn Dr |
$33.48 | 9,915 | 9,018 |
|
Brian G Orr
298 Washington St |
$44.15 | 11,152 | 9,077 |
|
Jeffrey M Stockman
298 Washington St |
$45.64 | 22,351 | 18,237 |
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 Gloucester, MA?
Based on public Medicaid payment data, the average Medicaid reimbursement for Office Visit in Gloucester, MA is $41.95 per claim, based on 88,661 claims from 30 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 Gloucester, MA?
There are 30 Medicaid providers offering Office Visit related services in Gloucester, MA according to public payment data.
What is the price range for Office Visit in Gloucester, MA?
Medicaid reimbursement for Office Visit in Gloucester, MA ranges from $0.00 to $80.44 per claim, with an average of $41.95. 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 Gloucester, MA
Non-Emergency Medical Transportation
Avg $25.87
156,692 claims
Ambulance Transport
Avg $59.19
100,508 claims
Dental Cleaning & Exam
Avg $37.57
39,720 claims
Personal Care Services
Avg $100.75
33,704 claims
Home Health Visit
Avg $331.99
25,631 claims
Psychiatric Evaluation
Avg $61.85
19,793 claims
EKG / ECG (Electrocardiogram)
Avg $4.76
15,539 claims
Nursing Facility Care
Avg $7.05
14,296 claims