Average Medicaid Office Visit Payments in Pennsburg, PA: $44.29
Avg. Paid
$44.29
Range
$24.08 – $53.52
Total Claims
4,714
Providers
9
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 Pennsburg, PA
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Madushini Gunawardana Craner
101 W 7Th St Ste 2A |
$53.52 | 1,099 | 1,055 |
|
Priscilla Jean Benner
2781 Geryville Pike |
$43.99 | 956 | 914 |
|
Brittany Kuperavage
2793 Geryville Pike Ste 200 |
$48.57 | 889 | 860 |
|
Kaitlin Borelli
925 Main St |
$33.16 | 438 | 420 |
|
Krystal Trinkle
101 W 7Th St Ste 2C |
$40.82 | 392 | 370 |
|
Jason Fiske-Baier
158 Main St |
$24.08 | 262 | 229 |
|
Carol L Henwood
101 W 7Th St Ste 2A |
$40.52 | 241 | 212 |
|
Tina M Myers
2793 Geryville Pike |
$40.51 | 226 | 216 |
|
Andrew J Buck
101 W 7Th St |
$42.59 | 211 | 202 |
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 Pennsburg, PA?
Based on public Medicaid payment data, the average Medicaid reimbursement for Office Visit in Pennsburg, PA is $44.29 per claim, based on 4,714 claims from 9 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 Pennsburg, PA?
There are 9 Medicaid providers offering Office Visit related services in Pennsburg, PA according to public payment data.
What is the price range for Office Visit in Pennsburg, PA?
Medicaid reimbursement for Office Visit in Pennsburg, PA ranges from $24.08 to $53.52 per claim, with an average of $44.29. 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 Pennsburg, PA
Physical Therapy
Avg $105.22
21,980 claims
Blood Work & Lab Tests
Avg $11.13
401 claims
Vaccines & Immunizations
Avg $16.45
240 claims
Ambulance Transport
Avg $94.32
120 claims
Nursing Facility Care
Avg $52.12
53 claims
Podiatry (Foot Care)
Avg $5.64
38 claims
Hearing Test (Audiometry)
Avg $1.67
34 claims
Dental Cleaning & Exam
Avg $23.91
13 claims