Average Medicaid Office Visit Payments in Indiana, PA: $44.54
Avg. Paid
$44.54
Range
$0.00 – $106.75
Total Claims
101,386
Providers
86
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 Indiana, PA
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Christina B Lubold
2255 Philadelphia St |
$38.91 | 10,097 | 9,120 |
|
Debra Ann Schettini-Prasko
2128 Oakland Ave |
$73.18 | 6,852 | 6,718 |
|
Nichole Lynn Lysick
15 S 8Th St Ste 200 |
$50.55 | 6,422 | 6,072 |
|
Bosco Edric Noronha
1265 Wayne Avenue |
$33.62 | 6,174 | 6,006 |
|
Michael Joseph Dziagwa
879 Hospital Rd |
$42.07 | 4,119 | 3,745 |
|
Shenggao Han
625 Rustic Lodge Rd |
$48.48 | 4,112 | 3,804 |
|
Megan R Shugarts
1265 Wayne Ave Ste 102 |
$47.48 | 3,883 | 3,539 |
|
Mohammed N. Islam
1265 Wayne Ave |
$30.22 | 3,235 | 1,799 |
|
Nihar Sharad Ghate
1265 Wayne Ave Ste 307 |
$20.31 | 3,035 | 2,712 |
|
Brandon Hinderliter
835 Hospital Rd |
$71.72 | 2,828 | 2,774 |
|
Karam K Pathan
590 Indian Springs Rd |
$20.36 | 2,669 | 1,630 |
|
Shiva Kumar Reddy Mukkamalla
Irmc Cancer Center 850 Hospital Road First Floor |
$65.15 | 2,498 | 2,308 |
|
Mushtaq Ali Syed
1265 Wayne Ave Ste 103 |
$39.15 | 2,399 | 2,367 |
|
Xianwen Qiao
625 Rustic Lodge Rd |
$42.13 | 2,261 | 2,106 |
|
Donalyn Troubles Plutto
835 Hospital Rd |
$79.17 | 1,903 | 1,874 |
|
Robert Paul Snyder
625 Rustic Lodge Rd |
$47.88 | 1,885 | 1,777 |
|
Francis J Grego
835 Hospital Road |
$77.77 | 1,770 | 1,749 |
|
Brittany D'Nel Lindahl
2128 Oakland Ave |
$63.93 | 1,630 | 1,596 |
|
Bethany Vernocy Jablunovsky
835 Hospital Road |
$60.76 | 1,621 | 1,599 |
|
Randeep C Hayer
793 Old Route 119 Hwy N |
$0.96 | 1,598 | 1,310 |
|
Sara Zorak
835 Hospital Rd |
$58.63 | 1,571 | 1,545 |
|
Stephanie Jo Bressler
841 Hospital Rd Ste 3100 |
$22.77 | 1,530 | 1,478 |
|
Jonathan Scholl
120 Irmc Dr |
$24.76 | 1,436 | 1,411 |
|
Therese M Wilson
120 Irmc Dr Ste 130 |
$40.06 | 1,399 | 1,378 |
|
Annette Kubalek
1265 Wayne Ave Ste 103 |
$41.62 | 1,282 | 1,264 |
|
Laura A Dziagwa
879 Hospital Rd |
$39.68 | 1,247 | 1,056 |
|
Jason Michael Sharbaugh
879 Hospital Rd |
$47.60 | 1,147 | 1,086 |
|
Howard P Miller
120 Irmc Dr |
$33.02 | 1,116 | 1,053 |
|
David B Wilson
120 Irmc Dr |
$35.29 | 1,073 | 1,014 |
|
Roberto Esteban Turnbull
1177 S 6Th St |
$36.62 | 1,038 | 913 |
|
John Baber
120 Irmc Dr Ste 110 |
$40.68 | 1,027 | 974 |
|
David T Bizousky
120 Irmc Dr |
$35.40 | 1,006 | 965 |
|
Brian Stone
120 Irmc Dr Ste 100 |
$45.11 | 984 | 897 |
|
Joseph D Conti
1265 Wayne Ave |
$22.22 | 949 | 868 |
|
Kathryn Relampagos Trinidad
879 Hospital Rd |
$46.17 | 906 | 876 |
|
Edward P Mcdowell
1265 Wayne Ave Ste 306 |
$33.09 | 820 | 810 |
|
Abbey Jane Chi
879 Hospital Rd |
$40.64 | 780 | 744 |
|
Medexpress Urgent Care, Pc - Pennsylvania
2128 Oakland Ave |
$55.33 | 759 | 716 |
|
Debra Murdick
850 Hospital Rd Ste 1300 |
$35.26 | 757 | 661 |
|
Michael R Stever
1075 Indian Springs Road |
$30.64 | 724 | 601 |
|
Joseph Lamantia
1690 Saltsburg Ave |
$34.30 | 652 | 567 |
|
Michael Sauter
850 Hospital Rd Ste 2200 |
$30.62 | 615 | 604 |
|
Ronald Brandon Trale
120 Irmc Dr |
$31.22 | 556 | 530 |
|
Shelby Marie Hawk
1097 Oak St |
$48.87 | 504 | 491 |
|
Bonnie Cramer
841 Hospital Rd Ste 2300 |
$44.65 | 482 | 473 |
|
Patrick Robert Shannon
835 Hospital Road |
$36.86 | 465 | 444 |
|
Gary William Lewis
1265 Wayne Ave Ste 306 |
$28.87 | 463 | 451 |
|
Craig C Mckirgan
120 Irmc Dr |
$39.42 | 434 | 413 |
|
Maria Olivia Stiles
835 Hospital Rd Ste 3200 |
$40.02 | 421 | 409 |
|
Durre Ahmed
2121 Shelly Dr |
$32.75 | 412 | 396 |
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 Indiana, PA?
Based on public Medicaid payment data, the average Medicaid reimbursement for Office Visit in Indiana, PA is $44.54 per claim, based on 101,386 claims from 86 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 Indiana, PA?
There are 86 Medicaid providers offering Office Visit related services in Indiana, PA according to public payment data.
What is the price range for Office Visit in Indiana, PA?
Medicaid reimbursement for Office Visit in Indiana, PA ranges from $0.00 to $106.75 per claim, with an average of $44.54. 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 Indiana, PA
Physical Therapy
Avg $19.03
52,128 claims
Emergency Room Visit
Avg $77.78
46,720 claims
Ambulance Transport
Avg $100.43
32,131 claims
Speech Therapy
Avg $33.51
29,482 claims
Blood Work & Lab Tests
Avg $13.91
28,625 claims
Chiropractic Care
Avg $12.33
27,335 claims
Case Management Services
Avg $71.90
15,591 claims
Home Health Visit
Avg $95.86
11,105 claims