Average Medicaid Office Visit Payments in North Wales, PA: $26.11
Avg. Paid
$26.11
Range
$2.95 – $37.30
Total Claims
2,916
Providers
6
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 North Wales, PA
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Scott H Culp
212 N Main St Ste 203 |
$25.94 | 1,942 | 1,837 |
|
Arun Thomas
212 N Main St Ste 203 |
$30.06 | 725 | 675 |
|
Jeffrey B Ellis
1425 Horsham Rd |
$2.95 | 135 | 124 |
|
Lateefa Antrom
1427 Horsham Rd |
$35.94 | 81 | 79 |
|
Robert H Gordon
1425 Horsham Rd |
$6.82 | 19 | 14 |
|
Heather Elizabeth Morris
1210 Bethlehem Pike Ste B7 |
$37.30 | 14 | 14 |
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 North Wales, PA?
Based on public Medicaid payment data, the average Medicaid reimbursement for Office Visit in North Wales, PA is $26.11 per claim, based on 2,916 claims from 6 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 North Wales, PA?
There are 6 Medicaid providers offering Office Visit related services in North Wales, PA according to public payment data.
What is the price range for Office Visit in North Wales, PA?
Medicaid reimbursement for Office Visit in North Wales, PA ranges from $2.95 to $37.30 per claim, with an average of $26.11. 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 North Wales, PA
Physical Therapy
Avg $26.02
35,182 claims
Nursing Facility Care
Avg $33.94
10,144 claims
Dental Cleaning & Exam
Avg $26.56
5,531 claims
Speech Therapy
Avg $87.53
3,863 claims
Dental Filling
Avg $65.77
2,409 claims
Tooth Extraction
Avg $71.11
1,517 claims
Eye Exam
Avg $39.50
1,010 claims
Root Canal
Avg $91.52
410 claims