Based on public Medicaid payment data.

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
Elizabeth Anne Zeeck 1821 S Stoughton Rd	$22.19	12	12
Frank Jung 700 S Park St	$19.85	12	12
Sarah Maria Hill Donohue 451 Junction Rd	$47.79	12	12
Christopher A. Nestleroad 451 Junction Rd	$16.08	12	12
Elizabeth M Jermier 700 South Park Street	$21.15	12	12
Sarah Lai 600 Highland Ave	$31.06	12	12
Kellia J Hansmann 3209 Dryden Dr	$62.16	12	12
Bradley Arthur Smith Uw Hospital And Clinics	$136.49	12	12
Kevin T Wyne 600 Highland Ave	$29.63	12	12
Sara Heintzman Galli 1211 Fish Hatchery Rd	$56.17	12	12
Melissa E Jennerjohn 1821 S Stoughton Rd	$16.86	12	12
Peter Frosio Nichol 600 Highland Ave	$77.50	12	12
Margarita Nisman German 750 University Row	$30.31	12	12
Margaret A. Brooks 621 Science Dr	$22.37	12	12
Rachel Louise Bielmeier 451 Junction Rd	$0.00	12	12
Ronak Mehta 1620 Waunona Way	$3.55	12	12
Richard L Ellis 7509 Farmington Way	$10.49	12	12
Amit Satish Chitnis 700 S Park St	$0.00	12	12
Sayee Sundar Alagusundaramoorthy Uw Hospitals And Clinics 600 Highland Ave	$46.83	12	12
Sarah Beth Affeldt 600 Highland Avenue	$13.62	12	12
Christina M Morganti 600 Highland Ave	$79.04	12	12
Michael B Walsh 1 S Park St	$14.72	12	12
Istvan Danko 600 Highland Ave	$42.09	12	12
Carolyn Sue Christenson 5113 S Hill Dr	$0.00	12	12
Susan R Davidson 700 S Park St	$0.00	12	12
James B Bigham 7102 Mineral Point Rd	$20.82	12	12
Michael W Ritter 7610 Sawmill Rd	$15.37	12	12
Belinda Wenjie Vuong Uw Hospitals And Clinics	$76.57	12	12
Emerson Kendall 525 E Main St Apt 306	$136.94	12	12
Meredith Winkelhake 600 Highland Ave	$28.62	12	12
Kristin M Berg 2880 University Ave	$7.61	12	12
Melissa Mclean 700 S Park St Ste A	$47.34	12	12
Hannah Cavaleri 600 Highland Ave	$27.33	12	12
Kelly S Mack 6001 Research Park Blvd	$3.49	12	12
Anjali S Rao 1500 Highland Ave	$102.28	12	12
Kurtis J Swanson 600 Highland Ave	$31.91	12	12
Emelle S Holmes-Drammeh 20 S Park St	$24.63	12	12
Kristen L Panther 5249 E Terrace Dr	$3.97	12	12
Alaa A Abd-Elsayed 600 Highland Ave	$46.24	12	12
Rana C Leer Haupt 621 Science Dr	$8.19	12	12
Megan N Sommers 4602 Eastpark Blvd	$30.57	12	12
Zehra Husain 600 Highland Ave	$47.58	12	12
Kathryn L Sklenar 451 Junction Rd	$14.46	12	12
Erin B Trost 8202 Excelsior Dr	$27.66	13	12
Subarna Mani Dhital 451 Junction Rd	$29.53	13	12
Amanda S Carlson 1211 Fish Hatchery Rd	$35.77	13	12
Zachary David Goldberger 600 Highland Ave	$32.04	13	13
T Michael Nork 2880 University Ave	$2.18	13	13
Krystal J Boardman 2402 Winnebago St	$7.27	13	12
Kimberly J Miller 451 Junction Rd	$21.35	13	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 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.

Average Medicaid Office Visit Payments in Madison, WI: $49.22

Providers Offering Office Visit in Madison, WI

What to Expect: Office Visit

Cost Components

Frequently Asked Questions

Office Visit in Other Cities

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