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
Jefferson Acute Care Physicians, Pc 2607 Rhawn St	$28.15	12	12
Anne Marie Sullivan 1528 Walnut St Ste 950	$0.00	12	12
Gaye Suzette Riddick-Burden 833 Chestnut St	$32.02	12	12
Tiffany Fernandes Gee 3401 N Broad St Fl 7	$0.00	12	12
Marc Kevin Rubenzik 233 S 10Th St	$3.05	12	12
Marc Jason Kim 1427 Vine St	$38.88	12	12
Akinbowale Olatokunbo Oyalowo 3400 Civic Center Blvd	$74.35	12	12
Joshua David Eisenberg 3401 Civic Center Blvd	$42.53	12	12
Michele Bernice Harper 3900 Woodland Ave	$94.62	12	12
Frank Milton Balis 3401 Civic Center Blvd	$65.19	12	12
Sara Dehbashi 909 Walnut St Fl 4	$30.84	12	12
Fatima Zahara Syed 1025 Walnut St	$39.20	12	12
Pak Shan Parkson Leung 5401 Old York Rd	$141.73	12	12
Gina Santucci 34 Street And Civic Center Blvd	$72.62	12	12
Laura Emmons 3400 Civic Center Blvd	$9.07	12	12
Shailaja Nair 700 Walnut St Fl 2	$13.55	12	12
Stc Pediatrics Llc 160 E Erie Ave	$91.04	12	12
Adam Guss 9501 Roosevelt Blvd Ste 501	$52.42	12	12
Shannon Voelker 251 E Bringhurst St	$0.00	12	12
Stanley W Hatch 1200 W Godfrey Ave	$56.18	12	12
Stephanie Mcconnell Moleski 1101 Chestnut St	$23.17	12	12
Ya-Feng Liang 3737 Market St	$0.00	12	12
Larry M. Borowsky 525 Jamestown St	$5.05	12	12
David Gabriel Prado 230 N Broad St	$65.05	12	12
Matthew Ho 3400 Spruce St	$81.39	12	12
Justin Derosa 1528 Walnut St Ste 950	$102.86	12	12
Nina Ngo 700 Cottman Ave	$55.33	12	12
Gregory Kanski 1010 Arch St Unit 507	$30.19	12	12
Kamillah Wood 34Th & Civic Center Blvd	$87.82	12	12
Caitlin Elgarten 3500 Civic Center Blvd	$102.05	12	12
Bhargava Krishna Nelluri 5501 Old York Rd	$72.20	12	12
Carolyn Wood 7996 Oxford Ave	$58.06	12	12
Lauren Rachel Hersh 833 Chestnut St	$33.22	12	12
Graham Seering 5800 Ridge Ave	$50.90	12	12
Amanda Muir 3401 Civic Center Blvd	$82.56	12	12
Asyia Shareen Ahmad 219 N Broad St	$30.52	12	12
Kenneth L. Zeitzer 5501 Old York Road	$19.33	12	12
Carmen Patrascu 700 Spruce St Ste 403	$61.78	12	12
Jessica Irene Rodini 3509 N Broad St	$48.67	12	12
Anoop Manikarnika Raman 1080 N Delaware Ave Ste 800	$16.16	12	12
Nina R. O'Connor 1316 W Ontario St	$31.31	12	12
Andres Deik Acosta Madiedo 800 Spruce Street	$52.42	12	12
Andrew J Collier 2410-14 S Broad St	$0.00	12	12
John R Fontanilla 4453 Castor Ave	$36.64	12	12
James Ryan Mark 333 Cottman Ave	$36.12	12	12
Andrew J Bauer 3401 Civic Center Blvd	$99.33	12	12
Crystal B. Chen 3401 N Broad St	$38.13	12	12
Quadeer Mohammed Fasihuddin 245 N 15Th St	$106.24	12	12
Rachel Erica Hilburg 3400 Spruce St	$39.98	12	12
Stephen J Gluckman 51 N 39Th St	$81.27	12	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 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)