Average Medicaid Office Visit Payments in Lancaster, PA: $39.75
Avg. Paid
$39.75
Range
$0.00 – $265.97
Total Claims
607,480
Providers
496
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 Lancaster, PA
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Anne-Marie Derrico
304 N Water St |
$0.16 | 28,553 | 26,264 |
|
Peter G Moyer
304 N Water St |
$7.80 | 17,409 | 12,961 |
|
Afsheen Abdul Karim
2145 Noll Dirve |
$51.27 | 17,239 | 14,065 |
|
Matthew A Weitzel
802 New Holland Avenue |
$0.14 | 14,910 | 13,917 |
|
Douglas E Leaman
515-B Hershey Ave. |
$0.21 | 14,808 | 13,491 |
|
Derick S Brubaker
515B Hershey Ave |
$0.10 | 14,709 | 13,640 |
|
Madhumita Sadhukhan
802 New Holland Ave Ste 200 |
$0.25 | 14,509 | 13,500 |
|
Stephen G. Diamantoni
734 N Franklin St |
$44.99 | 14,320 | 13,093 |
|
Benjamin R Snell
555 N Duke St |
$50.27 | 14,052 | 13,245 |
|
Robert G Doe
330 N Arch St |
$56.89 | 13,047 | 12,112 |
|
Adam Voelckers
233 College Ave Ste 302 |
$40.40 | 11,248 | 9,853 |
|
Robert J Shelly
625 S Duke St |
$24.84 | 10,262 | 8,198 |
|
Kamlesh Raj Acharya
2145 Noll Dr |
$50.71 | 9,973 | 8,625 |
|
Greta L Laube
2150 Noll Drive, Suite 100 |
$45.87 | 9,434 | 8,490 |
|
Jay Kyle Zimmerman
231 Granite Run Dr |
$51.06 | 9,044 | 5,988 |
|
Brian A Jones
2118 Spring Valley Rd |
$44.21 | 8,101 | 8,001 |
|
Kelly Ann Reese
802 New Holland Ave Ste 200 |
$13.42 | 7,475 | 7,091 |
|
Scott Schucker
555 N Duke St |
$40.87 | 5,792 | 5,423 |
|
Gayle B Sisbarro
1160 Manheim Pike |
$53.97 | 5,433 | 4,556 |
|
Ewain P Wilson
810 Plaza Blvd |
$71.77 | 5,274 | 4,650 |
|
Denise N Cope
101 Abbeyville Rd |
$45.07 | 5,078 | 4,822 |
|
Erica Leigh Coulter
625 S Duke St |
$0.19 | 4,965 | 4,379 |
|
Thomas C. Raff
2118 Spring Valley Rd |
$44.44 | 4,888 | 4,826 |
|
Devyani Chowdhury
1834 Oregon Pike |
$56.30 | 4,804 | 4,352 |
|
Federico Ariel Ceppa
625 S Duke St |
$0.04 | 4,754 | 4,506 |
|
Jennifer E Brubaker
304 N Water St |
$0.65 | 4,607 | 4,221 |
|
David Kenneth Brown
2150 Noll Dr |
$44.65 | 4,557 | 4,311 |
|
William A Fife
333 N Arch St |
$42.94 | 4,525 | 4,220 |
|
Stephen F. Gold
2920 Marietta Ave |
$34.57 | 4,506 | 4,100 |
|
Union Community Care
802 New Holland Ave Ste 200 |
$0.95 | 4,440 | 3,686 |
|
Jasen Tjahjadi
555 N Duke St |
$0.10 | 4,195 | 2,408 |
|
Jean David Dumornay
555 North Duke Street |
$45.88 | 4,182 | 4,135 |
|
Louis H. Trotman
51 Peters Rd |
$42.34 | 4,164 | 4,094 |
|
Matthew Sauder
2112 Harrisburg Pike |
$56.44 | 4,154 | 3,907 |
|
Christian Hermansen
540 N Duke St |
$44.81 | 4,109 | 3,855 |
|
Colin Christopher Heinle
170 N Pointe Blvd |
$85.29 | 4,101 | 3,822 |
|
Victor Manuel Da Costa
1430 Harrisburg Pike |
$122.40 | 4,045 | 3,979 |
|
Union Community Care
304 N Water St |
$1.10 | 4,000 | 3,350 |
|
Steven Nolan Dorf
810 Plaza Blvd |
$144.64 | 3,954 | 3,861 |
|
Mark H Johnston
2112 Harrisburg Pike |
$61.37 | 3,900 | 3,824 |
|
Thomas Gates
802 New Holland Ave Ste 200 |
$0.00 | 3,862 | 3,310 |
|
Holly Frost
1570 Fruitville Pike Ste 100 |
$75.39 | 3,791 | 3,619 |
|
Stephen D Ratcliffe
304 N Water St |
$0.06 | 3,599 | 3,288 |
|
Stephen Olin
540 N Duke St |
$40.89 | 3,494 | 3,276 |
|
Laura Leaman
555 N Duke St |
$44.51 | 3,320 | 3,235 |
|
Stephanie Jo Ashbaugh
264 Granite Run Dr |
$52.36 | 3,241 | 3,073 |
|
Althea Keener
304 N Water St |
$0.06 | 3,228 | 3,048 |
|
Jon David Lepley
540 Duke St |
$38.83 | 3,089 | 2,578 |
|
Vito J Dicamillo
2118 Spring Valley Rd |
$43.61 | 3,083 | 3,057 |
|
John W Miller
810 Plaza Blvd |
$118.19 | 3,046 | 2,973 |
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 Lancaster, PA?
Based on public Medicaid payment data, the average Medicaid reimbursement for Office Visit in Lancaster, PA is $39.75 per claim, based on 607,480 claims from 496 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 Lancaster, PA?
There are 496 Medicaid providers offering Office Visit related services in Lancaster, PA according to public payment data.
What is the price range for Office Visit in Lancaster, PA?
Medicaid reimbursement for Office Visit in Lancaster, PA ranges from $0.00 to $265.97 per claim, with an average of $39.75. 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 Lancaster, PA
Dental Cleaning & Exam
Avg $31.67
164,673 claims
Emergency Room Visit
Avg $85.60
150,561 claims
Case Management Services
Avg $65.68
149,372 claims
EKG / ECG (Electrocardiogram)
Avg $7.00
141,532 claims
Physical Therapy
Avg $55.22
134,531 claims
Speech Therapy
Avg $30.39
125,554 claims
Blood Work & Lab Tests
Avg $7.12
116,126 claims
Home Health Visit
Avg $144.39
94,116 claims