Average Medicaid Office Visit Payments in Newtown Square, PA: $56.18
Avg. Paid
$56.18
Range
$1.20 – $79.15
Total Claims
8,172
Providers
13
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 Newtown Square, PA
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Premier Orthopaedic And Sports Medicine Associates, Ltd
3809 W Chester Pike |
$79.15 | 3,974 | 3,666 |
|
Kevin Duprey
3855 W Chester Pike Ste 245 |
$51.56 | 1,290 | 1,158 |
|
Linda Vu Van
3930 W Chester Pike |
$18.92 | 757 | 682 |
|
Lauren Theriault
3855 W Chester Pike Ste 300 |
$1.20 | 642 | 560 |
|
Main Line Healthcare
3803 West Chester Pike |
$69.97 | 485 | 467 |
|
Sharon J Fleischer
3217 W Chester Pike Ste B |
$5.08 | 308 | 290 |
|
William James Monahan
113 Ridgefield Rd |
$55.12 | 279 | 245 |
|
Bernard Amiel Harris
18 Campus Blvd Ste 100 |
$34.99 | 145 | 122 |
|
Caitlin Madden
3319 W Chester Pike |
$26.49 | 132 | 117 |
|
Despina Tsirakoglou
300 Pheasant Lane |
$2.90 | 79 | 74 |
|
Michael F Prime
3855 W Chester Pike Ste 300 |
$43.71 | 52 | 49 |
|
Joshua Krosskove
3930 W Chester Pike |
$17.00 | 16 | 13 |
|
Jordan Klebanoff
3855 W Chester Pike Ste 340 |
$53.24 | 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 Newtown Square, PA?
Based on public Medicaid payment data, the average Medicaid reimbursement for Office Visit in Newtown Square, PA is $56.18 per claim, based on 8,172 claims from 13 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 Newtown Square, PA?
There are 13 Medicaid providers offering Office Visit related services in Newtown Square, PA according to public payment data.
What is the price range for Office Visit in Newtown Square, PA?
Medicaid reimbursement for Office Visit in Newtown Square, PA ranges from $1.20 to $79.15 per claim, with an average of $56.18. 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
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Las Vegas, NV
Avg $54.47
8,578,324 claims · 3512 providers
Other Procedures in Newtown Square, PA
Pathology & Lab Services
Avg $23.17
26,915 claims
Physical Therapy
Avg $17.28
20,091 claims
Speech Therapy
Avg $11.09
17,297 claims
Home Health Visit
Avg $95.87
16,860 claims
Ambulance Transport
Avg $8.17
11,815 claims
Substance Abuse Treatment
Avg $0.00
7,003 claims
Emergency Room Visit
Avg $105.84
3,530 claims
Nursing Facility Care
Avg $12.12
2,965 claims