Based on public Medicaid payment data.

Average Medicaid Office Visit Payments in Lexington, MA: $63.79

Avg. Paid

$63.79

Range

$2.82 – $151.66

Total Claims

83,870

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 Lexington, MA

Provider	Avg. Paid	Claims	Patients
Eliot Community Human Services 125 Hartwell Ave	$66.80	52,537	47,490
Rina Patel 4 Hadley Rd	$71.75	5,315	5,122
Glen D Gaebe 7 School St	$48.73	4,782	4,617
Gail Ruth Corson 10 Harbell St	$40.07	3,661	2,029
Jennifer Lynn Valentine 1 Forbes Rd	$64.31	2,983	2,916
Michelle L Palumbo 1 Maguire Rd	$34.24	2,192	2,187
Samuel Joseph Andonian 16 Clarke St	$67.47	2,039	1,744
Niravkumar Patel 4 Hadley Rd	$90.28	1,996	1,941
Eliot Community Human Services 125 Hartwell Ave	$88.79	1,168	1,109
Yamini Jagannath Howe 1 Maguire Rd	$85.65	1,073	1,048
Paolo Cassano 57 Bedford St Ste 230	$20.46	797	730
Stacie Rose 131 Hartwell Ave	$64.87	704	574
Jared E Duncan 21 Worthen Rd	$119.13	661	618
Linda Ann Lombardi 1666 Massachusetts Avenue	$7.70	402	394
Jessica L. Flowers 1 Maguire Rd	$49.83	367	367
Sylvia Massmanian 14 Green Ln	$33.90	357	345
Kenneth Matthew Mckay 110 Hartwell Ave Ste 101	$57.99	333	316
Christina Jaramillo Amerault 19 Muzzey St Ste 309	$52.01	273	231
Elizabeth Rosen 24 Hartwell Ave Ste 204	$36.92	195	194
Kathleen Ann Corley 482 Bedford St	$23.42	173	163
Alicia R Ruby 57 Bedford St	$21.35	159	152
Jessica A Krass 16 Hayden Ave	$19.87	143	130
Amanda Lyn Sheehan 10 Muzzey St Ste 9	$26.75	115	114
Patricia Ngaruiya 125 Hartwell Ave	$36.97	109	107
Alice S Lee 16 Hayden Ave	$11.03	97	85
Caitlin M Hartman 58 Bedford St	$57.84	86	86
R. Kirk Bohigian 16 Hayden Avenue	$30.46	85	84
Lexington Pediatrics, Llc 57 Bedford St Ste 100	$151.66	83	76
Hong Qian 57 Bedford St	$43.77	81	78
Eleanor R Gilbert 24 Blake Rd	$41.53	76	74
Jane L Berman 19 Muzzey St	$35.03	69	67
David V Ives 482 Bedford St	$23.85	69	66
Carewell Urgent Care Centers Of Ma, P.C 58 Bedford St	$113.19	67	66
Wendy Liane Wornham 19 Muzzey St	$57.26	65	61
Jill A Lamson 1 Forbes Rd	$52.15	63	62
Shivkumar H Jha 23 Wyman Rd	$21.38	57	46
Christine E. Winger 16 Hayden Ave	$25.96	54	50
Molly S. Lederman 57 Bedford St	$57.26	54	53
Amy Lazaro 57 Bedford St Ste 100	$53.36	48	48
Victoria J Arthur 19 Muzzey St	$64.92	42	39
Jane Ferro 57 Bedford St	$2.82	41	39
Steven P Abreu 16 Hayden Avenue	$24.23	39	39
Jennifer Mullon 21 Worthen Rd	$59.42	37	37
Paul Michael Bailey 482 Bedford St	$53.41	26	25
Poonam N. Doshi 21 Worthen Rd	$57.30	26	26
Andrew O Nichols 57 Bedford St	$44.27	18	16
Robyn Pauline Thom 1 Maguire Rd	$45.76	14	14
Margot Grace Hartunian 24 Hartwell Ave Ste 204	$6.48	14	13
Yaman Zorlu Eksioglu 76 Bedford St Ste 14	$97.38	13	13
Connie Y. Chen 16 Hayden Ave	$54.93	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 Lexington, MA?

Based on public Medicaid payment data, the average Medicaid reimbursement for Office Visit in Lexington, MA is $63.79 per claim, based on 83,870 claims from 50 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 Lexington, MA?

There are 50 Medicaid providers offering Office Visit related services in Lexington, MA according to public payment data.

What is the price range for Office Visit in Lexington, MA?

Medicaid reimbursement for Office Visit in Lexington, MA ranges from $2.82 to $151.66 per claim, with an average of $63.79. Private insurance and self-pay costs are typically higher than these Medicaid rates.

Average Medicaid Office Visit Payments in Lexington, MA: $63.79

Providers Offering Office Visit in Lexington, MA

What to Expect: Office Visit

Cost Components

Frequently Asked Questions

Office Visit in Other Cities

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