Average Medicaid Office Visit Payments in Herkimer, NY: $62.37
Avg. Paid
$62.37
Range
$0.00 – $140.35
Total Claims
41,408
Providers
28
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 Herkimer, NY
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Michelle L Gorski
237 E Steele St |
$58.88 | 10,815 | 9,143 |
|
Charlene J Macri
417 Henry Street |
$58.83 | 10,096 | 9,026 |
|
Margaret Scandura
321 E Albany St |
$32.64 | 4,755 | 4,508 |
|
Herkimer County
301 N Washington St Ste 2470 |
$140.35 | 3,848 | 3,772 |
|
Michael A Kore
321 E Albany St |
$39.75 | 1,616 | 1,456 |
|
Marvin S Rabinowitz
239 S Main St |
$70.87 | 1,432 | 1,130 |
|
Kristin Marie Luke
321 E Albany St |
$18.08 | 1,134 | 1,132 |
|
Andrew S Luck
3079 State Route 28 |
$82.89 | 1,130 | 1,129 |
|
Deepak Sharma
201 E State St |
$37.11 | 1,126 | 1,118 |
|
Stephen Hudyncia
690 W German St |
$65.90 | 1,007 | 955 |
|
Jesse Thomas Robillard
205 N Main St |
$82.88 | 684 | 545 |
|
Richard Andrew Nocella
301 N Washington St Ste 2300 |
$66.76 | 646 | 623 |
|
Debora Lee
321 E Albany St |
$52.11 | 643 | 616 |
|
Colette T Tangel
321 E Albany St |
$42.73 | 453 | 324 |
|
Irene Zasa Willett
321 E Albany St |
$27.81 | 444 | 442 |
|
Kurt Spencer Walburn
201 E State St |
$95.49 | 390 | 377 |
|
Larry Gene Martinson
201 E State St |
$92.36 | 229 | 214 |
|
Samantha Austin
321 E Albany St |
$58.31 | 193 | 177 |
|
David Winslow Pierce
205 N Main St |
$100.13 | 186 | 164 |
|
Cassandra M Pronti
321 E Albany St |
$18.74 | 167 | 163 |
|
Michele Irene Blanchard
321 E Albany St |
$21.24 | 122 | 121 |
|
Rebecca Hughes
201 East State St |
$21.18 | 102 | 100 |
|
William Martin Mccue
321 E Albany St |
$25.52 | 50 | 50 |
|
Colleen Conway-Edwards
321 E Albany St |
$0.00 | 42 | 28 |
|
Michael Earl Pontius
321 E Albany St |
$57.77 | 32 | 30 |
|
Priscilla Helen Garlock
435 N Main St |
$109.93 | 28 | 24 |
|
Crystal Lyn Bastien
321 E Albany St |
$37.19 | 26 | 25 |
|
Elizabeth Nyawira Kimani
321 E Albany St |
$10.03 | 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 Herkimer, NY?
Based on public Medicaid payment data, the average Medicaid reimbursement for Office Visit in Herkimer, NY is $62.37 per claim, based on 41,408 claims from 28 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 Herkimer, NY?
There are 28 Medicaid providers offering Office Visit related services in Herkimer, NY according to public payment data.
What is the price range for Office Visit in Herkimer, NY?
Medicaid reimbursement for Office Visit in Herkimer, NY ranges from $0.00 to $140.35 per claim, with an average of $62.37. 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 Herkimer, NY
Psychiatric Evaluation
Avg $123.44
20,432 claims
Physical Therapy
Avg $50.42
18,709 claims
Vaccines & Immunizations
Avg $8.13
13,241 claims
Home Health Visit
Avg $78.50
8,944 claims
Dental Cleaning & Exam
Avg $38.58
4,317 claims
Blood Work & Lab Tests
Avg $6.89
3,244 claims
Urinalysis & Urine Tests
Avg $1.80
2,598 claims
Nursing Facility Care
Avg $11.24
2,527 claims