Average Medicaid Office Visit Payments in Northborough, MA: $55.74
Avg. Paid
$55.74
Range
$1.97 – $103.48
Total Claims
30,056
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 Northborough, MA
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Gunardi Nyoto Irawan
162 Main St |
$69.23 | 6,934 | 6,188 |
|
Diana Trister
290 W Main St Ste 6 |
$31.47 | 6,085 | 5,538 |
|
Karl F Liebermann
112 Main St Ste 104 |
$59.65 | 3,266 | 2,840 |
|
Farhan Ibrahimi
10,010 K Shops Way |
$43.07 | 3,082 | 2,906 |
|
Urgent Care Centers Of Central Massachusetts, Llc
333 Sw Cutoff |
$92.13 | 2,209 | 2,147 |
|
Todd Christopher Malvey
1 E Main St |
$52.44 | 1,932 | 1,827 |
|
Margaret Tu-Anh Nguyen
300 W Main St Bldg B |
$103.48 | 1,463 | 1,432 |
|
Stacia Remsburg Sailer
333 Sw Cutoff |
$52.94 | 1,184 | 1,176 |
|
Veronica Lynn Hecht
24 W Main St |
$31.34 | 781 | 698 |
|
Shwetha S Adhikari
333 Sw Cutoff |
$68.22 | 726 | 689 |
|
Bryan Matthew Mcguirk
333 Sw Cutoff |
$48.34 | 648 | 627 |
|
Irfana Abdulhameed
112 Main St Ste 115 |
$5.29 | 447 | 440 |
|
Apeksha Tripathi
112 Main St |
$61.99 | 404 | 380 |
|
Melani Gerenia
106 W Main St Ste 3 |
$1.97 | 356 | 110 |
|
Mikhail Novikov
318 Main St Ste 165 |
$21.37 | 142 | 89 |
|
Michael A Reyes
333 Sw Cutoff |
$61.63 | 138 | 134 |
|
Kate Ann Gagnon
318 Main Street |
$47.75 | 100 | 79 |
|
Stacey Murphy
24 W Main St |
$61.17 | 95 | 95 |
|
Justine Doyon
24 W Main St |
$6.84 | 40 | 40 |
|
Joel A Hurwitz
112 Main St |
$64.85 | 24 | 24 |
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 Northborough, MA?
Based on public Medicaid payment data, the average Medicaid reimbursement for Office Visit in Northborough, MA is $55.74 per claim, based on 30,056 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 Northborough, MA?
There are 20 Medicaid providers offering Office Visit related services in Northborough, MA according to public payment data.
What is the price range for Office Visit in Northborough, MA?
Medicaid reimbursement for Office Visit in Northborough, MA ranges from $1.97 to $103.48 per claim, with an average of $55.74. 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 Northborough, MA
Non-Emergency Medical Transportation
Avg $51.61
109,219 claims
Dental Cleaning & Exam
Avg $37.51
33,800 claims
Nursing Facility Care
Avg $20.97
23,155 claims
Speech Therapy
Avg $20.71
6,587 claims
Physical Therapy
Avg $10.67
4,394 claims
Eye Exam
Avg $31.25
4,376 claims
Ambulance Transport
Avg $89.91
3,826 claims
Dental Filling
Avg $76.24
3,583 claims