Average Medicaid Office Visit Payments in Madison, WI: $49.22
Avg. Paid
$49.22
Range
$0.00 – $660.13
Total Claims
1,187,844
Providers
1,194
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 Madison, WI
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
University Of Wisconsin Hospitals And Clinics Authority
600 Highland Ave |
$71.58 | 402,073 | 325,577 |
|
Meriter Hospital, Inc.
202 S Park St |
$55.51 | 25,450 | 19,091 |
|
Planned Parenthood Of Wisconsin
2222 S Park St |
$32.80 | 16,747 | 15,927 |
|
Jaime Lynn Kremer
313 Price Pl Ste 208 |
$35.04 | 15,394 | 7,463 |
|
Therese Rowe
1 Point Pl Ste 200 |
$33.30 | 10,546 | 5,481 |
|
Trisha E Schimek
701 Dane St |
$0.12 | 10,220 | 6,675 |
|
Zenia Sarker
2601 W Beltline Hwy |
$32.34 | 9,307 | 5,074 |
|
Randi L Kent
115 W Doty St |
$39.20 | 7,599 | 3,790 |
|
Nicholas C Lane
8102 Wellness Way |
$36.68 | 7,081 | 6,413 |
|
Sobia Kirmani Moe
6302 Odana Rd |
$30.27 | 7,013 | 5,646 |
|
Katherine F Moriarty
1211 Fish Hatchery Rd |
$38.14 | 6,430 | 5,984 |
|
Daniel Scott Towns
600 Highland Ave |
$3.13 | 5,446 | 4,767 |
|
Maria Rosa
20 S Park St |
$38.72 | 4,868 | 4,116 |
|
Douglas Gregory Olk
2402 Winnebago St |
$42.79 | 4,597 | 4,211 |
|
Marsha E Ritter Jones
600 Highland Ave |
$45.84 | 4,160 | 3,807 |
|
Nauman Khurshid
202 S Park St |
$74.92 | 4,156 | 3,081 |
|
Kate Angela Borromeo
2500 Overlook Terrace |
$2.75 | 4,092 | 3,776 |
|
Julia Marie Weiser
3434 E Washington Ave |
$30.09 | 3,926 | 3,462 |
|
Hannah Wakefield
5249 E Terrace Dr |
$181.90 | 3,855 | 3,535 |
|
Joong Eun Shin
1821 S Stoughton Rd |
$31.47 | 3,839 | 3,623 |
|
Jody C Epstein
1102 S Park St |
$33.42 | 3,834 | 3,193 |
|
Walker B Shapiro
3209 Dryden Dr |
$25.96 | 3,807 | 3,298 |
|
Kristy L Fitzpatrick
1211 Fish Hatchery Rd |
$37.76 | 3,805 | 3,459 |
|
Janna Swearingen
600 Highland Ave |
$35.48 | 3,740 | 2,434 |
|
Kenneth James Herrmann
2727 Marshall Court |
$24.29 | 3,658 | 3,413 |
|
Stephanie M Salas
1821 S Stoughton Rd |
$32.05 | 3,635 | 3,323 |
|
Bhawani Ballamudi
1821 S Stoughton Rd |
$44.10 | 3,595 | 3,301 |
|
Lydia T. Mawad Melendez
202 S Park St |
$63.52 | 3,559 | 3,292 |
|
Kimberly D Day
1821 S Stoughton Rd |
$30.89 | 3,452 | 2,984 |
|
Luke Johnson
1821 S Stoughton Rd |
$29.09 | 3,431 | 3,167 |
|
Barkha Amlani
600 Highland Ave |
$6.66 | 3,423 | 3,383 |
|
Nicholas A Hallett
1821 S Stoughton Rd |
$35.25 | 3,423 | 3,185 |
|
Access Community Health Centers, Inc.
1102 S Park St |
$0.00 | 3,387 | 3,077 |
|
Chad Martin Wagner
333 E Campus Mall Rm 5131 |
$74.26 | 3,378 | 2,966 |
|
Yushane C Shih
621 Science Dr |
$36.66 | 3,289 | 3,159 |
|
Melanie Schmitt
2880 University Ave |
$40.47 | 3,265 | 2,973 |
|
Terrance E Donnal
1821 S Stoughton Rd |
$31.66 | 3,228 | 2,960 |
|
Elizabeth Rose Doherty
2202 S Park St |
$23.65 | 3,211 | 2,889 |
|
Access Community Health Centers, Inc.
3434 E Washington Ave |
$0.08 | 3,184 | 2,717 |
|
Kyle A Fischer
1821 S Stoughton Rd |
$62.14 | 3,124 | 2,955 |
|
Travis B Copeland
752 N High Point Rd |
$37.84 | 3,104 | 2,815 |
|
Timothy R Mchugh
752 N High Point Rd |
$38.37 | 2,947 | 2,711 |
|
Neszta Wahmhoff
4122 E Towne Blvd |
$19.07 | 2,941 | 2,765 |
|
Nicholas Dimitri David
Uw Hospitals And Clinics |
$80.60 | 2,939 | 2,647 |
|
Carey Dachik
3434 E Washington Ave |
$20.22 | 2,938 | 2,618 |
|
Alexandra Mcmurray
2727 Marshall Ct |
$30.05 | 2,913 | 2,262 |
|
Nate Sullivan
20 S Park St |
$27.06 | 2,908 | 2,660 |
|
Michael Leasure
5618 Odana Rd |
$55.32 | 2,904 | 2,420 |
|
Debra A Shenoi
1821 S Stoughton Rd |
$24.62 | 2,816 | 2,636 |
|
Brian Paul Jennett
600 Highland Ave |
$11.14 | 2,815 | 2,689 |
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 Madison, WI?
Based on public Medicaid payment data, the average Medicaid reimbursement for Office Visit in Madison, WI is $49.22 per claim, based on 1,187,844 claims from 1194 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 Madison, WI?
There are 1194 Medicaid providers offering Office Visit related services in Madison, WI according to public payment data.
What is the price range for Office Visit in Madison, WI?
Medicaid reimbursement for Office Visit in Madison, WI ranges from $0.00 to $660.13 per claim, with an average of $49.22. 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 Madison, WI
Substance Abuse Treatment
Avg $12.67
1,509,772 claims
Behavioral & Mental Health Therapy
Avg $110.40
1,504,873 claims
Blood Work & Lab Tests
Avg $11.76
1,154,690 claims
Emergency Room Visit
Avg $59.96
734,593 claims
X-Ray
Avg $5.48
502,669 claims
Physical Therapy
Avg $19.46
343,028 claims
EKG / ECG (Electrocardiogram)
Avg $5.11
290,457 claims
Dental Cleaning & Exam
Avg $17.30
243,954 claims