Based on public Medicaid payment data.

Average Medicaid Office Visit Payments in Philadelphia, PA: $47.22

Avg. Paid

$47.22

Range

$0.00 – $1,022

Total Claims

5,853,067

Providers

4,673

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 Philadelphia, PA

Provider	Avg. Paid	Claims	Patients
Sylvia Hsu 3401 N Broad St	$80.35	62,843	61,135
Elana Mcdonald 3380 Memphis St	$75.68	59,644	53,500
Daniel Yanfeng Lin 3353 Cottman Ave	$50.61	50,101	33,615
Trisha L Acri 7198 Castor Ave	$43.19	41,605	29,209
Truong Nguyen 5746 Rising Sun Ave	$36.45	37,779	31,695
Pan American Mental Health Services Inc 4519 N 5Th St	$31.28	34,797	33,017
Fabian A Vengoechea 7600 Central Ave	$45.92	32,951	27,607
John Smyth Michel 7515 Stenton Ave	$53.44	27,788	24,820
Citywide Community Counseling Service Inc 537 E Allegheny Ave	$97.40	27,067	25,134
Rafael S Collazo 401 W Allegheny Ave	$26.26	25,979	22,374
Arun K Mohanty 135 E Lehigh Ave	$49.05	25,975	22,771
Harold Jacob Milstein 525 Jamestown St Ste 206	$54.42	25,606	25,039
Jon Andrew Shapiro 1740 South St	$48.92	24,920	21,257
Comhar Inc 2055 E Allegheny Ave	$61.18	23,712	22,655
Phuong C Voong 3229 Kensington Ave	$61.48	23,047	10,874
Jonathan B Levyn 3402 F St	$52.32	20,294	18,717
Jayne Henderson Brown 4510 Frankford Ave	$0.09	19,085	17,441
Lei O Zhang 432 N 6Th St	$0.12	18,384	16,491
Mohammad Ali Al-Bataineh 2945 N 5Th St	$34.68	18,118	17,518
Manavendra Bakhshi 100 E Lehigh Ave # Mab-204	$31.15	17,279	16,737
Irisaida Martinez 401-55 W Allegheny Ave	$0.30	16,987	14,814
John Anthony Crawford 3402 F St	$52.23	15,856	14,614
Zoya Berenson 2000 Grant Ave Ste 201	$31.63	15,762	12,088
Asociacion De Puertorriquenos En Marcha, Inc. 2921 N 5Th St	$22.71	15,508	14,534
Raquel Inniss 9331 Old Bustleton Ave Ste 201	$3.07	15,418	13,812
Louise G Murray 1635 Chestnut Street	$46.87	15,355	13,256
Jason Marc Schoenfeld 9501 Roosevelt Blvd Ste 506	$91.04	15,297	14,245
David M. Jaspan 5401 Old York Rd	$69.60	14,876	12,092
Best Behavioral Healthcare, Inc. 5043 Frankford Ave	$83.01	14,725	13,860
Philip J. Horn 1 Penn Blvd	$66.25	14,664	12,250
Gary R Salzman 5945 Lansdowne Ave	$44.18	14,644	12,605
Henry H. Su 841 E Hunting Park Ave	$0.03	14,575	12,173
Centralized Comprehensive Human Services, Inc. 112 N Broad St	$37.51	14,336	13,560
Elena Adamov 1427 Vine St	$51.86	14,274	13,604
Dr Warren E Smith Community Mental Health Mental Retardation & Substan 1315 Windrim Avenue	$18.06	14,115	13,375
Adam Raphael Rom 2520 Snyder Ave	$0.32	14,021	12,554
Sabrina N Sukhan 801 Spruce St.	$64.89	13,909	11,781
Path (People Acting To Help), Inc 1919 Cottman Ave	$48.18	13,729	12,823
Nimidia Oviedo 136 Diamond St	$58.23	13,398	12,884
Jerald Lalaguna Pelayo 5501 Old York Rd Ste 1	$0.62	13,323	8,741
Sarah Johnson 131 E Chelten Ave	$0.22	13,302	12,672
Bruce Donald Hopper 5843 Rising Sun Ave	$48.11	13,288	10,155
Enitan Adegite 160 E Erie Ave	$67.19	12,741	11,927
Horacio David Hares 5501 Old York Rd - Paley Building 1St Floor	$55.64	12,599	12,045
Nicole Helene Delarato 160 E Erie Ave	$53.90	12,496	11,823
Simon Yongquan Su 109 N 9Th St	$23.95	12,481	11,338
Ramesh Parchuri 161 E Lehigh Ave	$35.85	12,389	10,417
Hall-Mercer Cmh-Mrc Of Pennsylvania Hosp 245 S 8Th St	$57.31	12,356	11,914
Kathleen Jean Kirk 3461 Civic Center Blvd	$49.09	12,041	10,185
Elizabeth Carazo 133 W Hunting Park Ave	$59.97	12,000	11,096

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 Philadelphia, PA?

Based on public Medicaid payment data, the average Medicaid reimbursement for Office Visit in Philadelphia, PA is $47.22 per claim, based on 5,853,067 claims from 4673 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 Philadelphia, PA?

There are 4673 Medicaid providers offering Office Visit related services in Philadelphia, PA according to public payment data.

What is the price range for Office Visit in Philadelphia, PA?

Medicaid reimbursement for Office Visit in Philadelphia, PA ranges from $0.00 to $1,022 per claim, with an average of $47.22. Private insurance and self-pay costs are typically higher than these Medicaid rates.

Average Medicaid Office Visit Payments in Philadelphia, PA: $47.22

Providers Offering Office Visit in Philadelphia, PA

What to Expect: Office Visit

Cost Components

Frequently Asked Questions

Office Visit in Other Cities

Brooklyn, NY

New York, NY

Los Angeles, CA

Chicago, IL

Bronx, NY

Phoenix, AZ

Houston, TX

Las Vegas, NV

Other Procedures in Philadelphia, PA

Substance Abuse Treatment

Psychiatric Evaluation

Emergency Room Visit

X-Ray

Behavioral & Mental Health Therapy

Blood Work & Lab Tests

Dental Cleaning & Exam

EKG / ECG (Electrocardiogram)