Average Medicaid Office Visit Payments in Pelham, AL: $70.26
Avg. Paid
$70.26
Range
$0.00 – $221.96
Total Claims
34,788
Providers
24
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 Pelham, AL
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Shelby Mckee Knight
30 Racquet Club Pkwy |
$43.44 | 7,606 | 6,006 |
|
Michael Richard Eicher
2970 Pelham Pkwy |
$67.78 | 5,943 | 4,539 |
|
Shelby County Health Dept-Pelham Fp Clinic
2000 County Services Dr |
$221.96 | 5,264 | 4,815 |
|
Alexis Medina
130 Stonehaven Dr |
$10.70 | 3,546 | 836 |
|
David R Faber
1940 Highway 33 |
$48.42 | 3,102 | 2,831 |
|
Lloyd Johnson
120 Cahaba Valley Parkway |
$30.56 | 2,446 | 1,918 |
|
Mandy Leigh Williams
300 Big Mountain Cir |
$66.78 | 1,464 | 1,369 |
|
Kayla Bevels
333 Business Cir |
$51.00 | 1,077 | 923 |
|
James Paul Beretta
2501 Meadowview Lane |
$0.00 | 783 | 783 |
|
Loy Vaughan
120 Cahaba Valley Pkwy Ste 100 |
$37.78 | 641 | 586 |
|
Timothy Pattison Taylor
300 Big Mountain Road |
$28.49 | 591 | 491 |
|
Lauren Ashleigh Smith
2156 Highway 52 East |
$24.43 | 581 | 296 |
|
Eminence Urgent Care Llc
2156 Highway 52 E Ste 150 |
$54.34 | 433 | 404 |
|
Alaina Shelton Contestabile
2100 County Services Dr |
$8.39 | 380 | 372 |
|
Annie Brigham Andrews
333 Business Cir |
$65.66 | 222 | 168 |
|
Samuel Evan Carstensen
120 Cahaba Valley Pkwy Ste 100 |
$33.97 | 195 | 152 |
|
Medhelp Shelby, Llc
3170 Pelham Pkwy |
$60.88 | 182 | 163 |
|
Courtney Paschal
2508 Pelham Pkwy |
$37.21 | 81 | 73 |
|
Alexxis Reid
449 Weatherly Club Dr |
$72.97 | 75 | 65 |
|
Kaylen Renee Rhoades
2156 Highway 52 E Ste 150 |
$24.20 | 52 | 31 |
|
Ashley Rea Donahue
2000 County Services Dr |
$61.49 | 48 | 38 |
|
Kelley Nevels
300 Big Mountain Cir |
$0.00 | 28 | 15 |
|
Darrell Scott Prestridge
2122 Old Montgomery Hwy |
$4.28 | 25 | 13 |
|
Shayna Naledi Moulton
333 Business Cir |
$4.32 | 23 | 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 Pelham, AL?
Based on public Medicaid payment data, the average Medicaid reimbursement for Office Visit in Pelham, AL is $70.26 per claim, based on 34,788 claims from 24 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 Pelham, AL?
There are 24 Medicaid providers offering Office Visit related services in Pelham, AL according to public payment data.
What is the price range for Office Visit in Pelham, AL?
Medicaid reimbursement for Office Visit in Pelham, AL ranges from $0.00 to $221.96 per claim, with an average of $70.26. 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 Pelham, AL
Dental Cleaning & Exam
Avg $23.15
107,664 claims
Blood Work & Lab Tests
Avg $22.06
34,352 claims
Physical Therapy
Avg $46.62
29,558 claims
Speech Therapy
Avg $51.51
26,754 claims
Eye Exam
Avg $29.59
19,827 claims
Dental Filling
Avg $70.59
18,753 claims
Psychiatric Evaluation
Avg $64.06
14,583 claims
Durable Medical Equipment (DME)
Avg $22.89
9,363 claims