Average Medicaid Office Visit Payments in New York City, NY: $97.59
Avg. Paid
$97.59
Range
$13.03 – $133.01
Total Claims
16,533
Providers
20
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 New York City, NY
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Jessica Lang-Chi Au
39 West 29Th Street |
$104.32 | 13 | 12 |
|
Abdullah Mohammed Alanazi
345 E 37Th St |
$37.34 | 14 | 12 |
|
Nadezhda Belous
220 Madison Ave |
$87.08 | 15 | 15 |
|
Jenna Hamdan
1041 Third Ave |
$22.04 | 16 | 16 |
|
Jocelynn Faith Dillon
222 E 31St St |
$133.01 | 25 | 25 |
|
Scott Jay Richter
33 West 42Nd Street |
$19.02 | 27 | 27 |
|
David Stephenson Wellman
535 East 70Th St |
$88.77 | 27 | 24 |
|
Dusan I Pekovic
333 E 46 Street |
$60.00 | 52 | 51 |
|
Paulina Plaskon
Hospital For Special Surgery |
$57.90 | 112 | 94 |
|
Dana Shani
178 East 85 Street |
$128.35 | 189 | 183 |
|
Alice Jo Siegel
119 East 83Rd Street |
$22.62 | 254 | 136 |
|
Jonathan Ariel Kirsten
First Ave At 16Th St |
$75.44 | 428 | 410 |
|
Robert Stuart Glickman
530 First Ave |
$55.54 | 451 | 450 |
|
Gregory Brent Dodell
115 Central Park West |
$71.09 | 524 | 514 |
|
John G Larsen
1245 Park Ave |
$17.54 | 660 | 611 |
|
Kelly Brant Pike
1824 Madison Ave |
$13.03 | 989 | 944 |
|
Deborah Lynn Ottenheimer
103 5Th Avenue |
$96.58 | 1,023 | 620 |
|
Niculae Ciobanu
10 East 38Th Street |
$85.61 | 1,289 | 1,085 |
|
Blanton-Peale Institute
7 West 30Th Street |
$114.06 | 2,841 | 2,634 |
|
New York Eye & Ear Infirmary
310 East 14Th Street |
$120.23 | 7,584 | 7,180 |
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 New York City, NY?
Based on public Medicaid payment data, the average Medicaid reimbursement for Office Visit in New York City, NY is $97.59 per claim, based on 16,533 claims from 20 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 New York City, NY?
There are 20 Medicaid providers offering Office Visit related services in New York City, NY according to public payment data.
What is the price range for Office Visit in New York City, NY?
Medicaid reimbursement for Office Visit in New York City, NY ranges from $13.03 to $133.01 per claim, with an average of $97.59. 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 New York City, NY
Dental Cleaning & Exam
Avg $5.59
152,663 claims
Eye Exam
Avg $106.66
122,789 claims
Psychiatric Evaluation
Avg $133.41
64,952 claims
Dental Filling
Avg $10.28
47,201 claims
Tooth Extraction
Avg $11.99
35,960 claims
Prescription Medications
Avg $76.63
15,184 claims
Hearing Test (Audiometry)
Avg $68.09
14,372 claims
Blood Work & Lab Tests
Avg $5.88
12,898 claims