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 |
|---|---|---|---|
|
Paul A. G. Cohen
801 Spruce St |
$43.87 | 12 | 12 |
|
Laura Emmons
3400 Civic Center Blvd |
$9.07 | 12 | 12 |
|
Stc Pediatrics Llc
160 E Erie Ave |
$91.04 | 12 | 12 |
|
Adam Guss
9501 Roosevelt Blvd Ste 501 |
$52.42 | 12 | 12 |
|
Gaye Suzette Riddick-Burden
833 Chestnut St |
$32.02 | 12 | 12 |
|
Shannon Voelker
251 E Bringhurst St |
$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 |
|
Michele Bernice Harper
3900 Woodland Ave |
$94.62 | 12 | 12 |
|
Matthew Ho
3400 Spruce St |
$81.39 | 12 | 12 |
|
Frank Milton Balis
3401 Civic Center Blvd |
$65.19 | 12 | 12 |
|
Justin Derosa
1528 Walnut St Ste 950 |
$102.86 | 12 | 12 |
|
Nina Ngo
700 Cottman Ave |
$55.33 | 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 |
|
Gregory Kanski
1010 Arch St Unit 507 |
$30.19 | 12 | 12 |
|
Gina Santucci
34 Street And Civic Center Blvd |
$72.62 | 12 | 12 |
|
Bhargava Krishna Nelluri
5501 Old York Rd |
$72.20 | 12 | 12 |
|
Shailaja Nair
700 Walnut St Fl 2 |
$13.55 | 12 | 12 |
|
Graham Seering
5800 Ridge Ave |
$50.90 | 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 |
|
Jessica Irene Rodini
3509 N Broad St |
$48.67 | 12 | 12 |
|
David Gabriel Prado
230 N Broad St |
$65.05 | 12 | 12 |
|
Kamillah Wood
34Th & Civic Center Blvd |
$87.82 | 12 | 12 |
|
Caitlin Elgarten
3500 Civic Center Blvd |
$102.05 | 12 | 12 |
|
Carolyn Wood
7996 Oxford Ave |
$58.06 | 12 | 12 |
|
Crystal B. Chen
3401 N Broad St |
$38.13 | 12 | 12 |
|
Lauren Rachel Hersh
833 Chestnut St |
$33.22 | 12 | 12 |
|
Amanda Muir
3401 Civic Center Blvd |
$82.56 | 12 | 12 |
|
Asyia Shareen Ahmad
219 N Broad St |
$30.52 | 12 | 12 |
|
Charissa Montgomery
333 Cottman Ave |
$61.06 | 12 | 12 |
|
Timothy Wilson
1101 Chestnut St Fl 11 |
$72.58 | 12 | 12 |
|
Kenneth L. Zeitzer
5501 Old York Road |
$19.33 | 12 | 12 |
|
Carmen Patrascu
700 Spruce St Ste 403 |
$61.78 | 12 | 12 |
|
Anoop Manikarnika Raman
1080 N Delaware Ave Ste 800 |
$16.16 | 12 | 12 |
|
Northeast Community Center For Mental Health-Mental Retardation Inc.
4371 Waln St |
$0.00 | 12 | 12 |
|
Nina R. O'Connor
1316 W Ontario St |
$31.31 | 12 | 12 |
|
Kevin Scott Fay
51 N 39Th St |
$98.51 | 12 | 12 |
|
Andres Deik Acosta Madiedo
800 Spruce Street |
$52.42 | 12 | 12 |
|
Jefferson Acute Care Physicians, Pc
2607 Rhawn St |
$28.15 | 12 | 12 |
|
Anne Marie Sullivan
1528 Walnut St Ste 950 |
$0.00 | 12 | 12 |
|
Tiffany Fernandes Gee
3401 N Broad St Fl 7 |
$0.00 | 12 | 12 |
|
Andrew J Collier
2410-14 S Broad St |
$0.00 | 12 | 12 |
|
James Ryan Mark
333 Cottman Ave |
$36.12 | 12 | 12 |
|
John R Fontanilla
4453 Castor Ave |
$36.64 | 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.
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 Philadelphia, PA
Substance Abuse Treatment
Avg $57.23
5,131,687 claims
Psychiatric Evaluation
Avg $69.22
3,688,209 claims
Emergency Room Visit
Avg $135.52
3,661,931 claims
X-Ray
Avg $9.69
1,822,183 claims
Behavioral & Mental Health Therapy
Avg $119.23
1,618,868 claims
Blood Work & Lab Tests
Avg $6.85
1,492,079 claims
Dental Cleaning & Exam
Avg $29.51
1,399,541 claims
EKG / ECG (Electrocardiogram)
Avg $11.36
1,272,685 claims