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
Jessica Irene Rodini 3509 N Broad St	$48.67	12	12
Crystal B. Chen 3401 N Broad St	$38.13	12	12
Charissa Montgomery 333 Cottman Ave	$61.06	12	12
Timothy Wilson 1101 Chestnut St Fl 11	$72.58	12	12
Northeast Community Center For Mental Health-Mental Retardation Inc. 4371 Waln St	$0.00	12	12
Kevin Scott Fay 51 N 39Th St	$98.51	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
Joshua David Eisenberg 3401 Civic Center Blvd	$42.53	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
Shannon Voelker 251 E Bringhurst St	$0.00	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
Bhargava Krishna Nelluri 5501 Old York Rd	$72.20	12	12
Graham Seering 5800 Ridge Ave	$50.90	12	12
Behdad David Besharatian 3400 Spruce St	$45.87	12	12
Durga Borkar 840 Walnut St Ste 1020	$23.20	12	12
Carmela C Vittorio 3400 Spruce Street	$69.67	12	12
Curt Jan Heese 3401 N Broad St	$6.92	12	12
Sashank Prasad 3737 Market St Fl 8	$66.58	12	12
Jesse Goldman 3401 N Broad St	$41.16	12	12
Christina Smith Paul 3535 Market St	$35.44	12	12
Janos L Tanyi 3400 Civic Center Boulevard	$37.48	12	12
Donna Goelzer Myers 9892 Bustleton Ave	$36.17	12	12
Michael A Becker 4190 City Ave	$39.55	12	12
Helena Lax-Kamenicka 1513 Race St	$9.59	12	12
Rohit Gupta 3401 N Broad St	$50.54	12	12
Jeannette Marcelle Guziel 3401 N Broad St	$161.25	12	12
Wilma C Rossi 3401 Civic Center Blvd	$95.94	12	12
Pouya Khankhanian 3400 Spruce St	$177.92	12	12
Matthew Craig Hyman 3400 Spruce St	$53.11	12	12
Mohammed Andaleeb Chowdhury 3509 N Broad St	$70.29	12	12
Joshua Cooper 3509 N Broad St	$95.34	12	12
Rima Alkasem 3509 N Broad St	$30.04	12	12
Judith Heredia 833 Chestnut Street	$38.50	12	12
City Of Philadelphia 4400 Haverford Ave	$0.00	12	12
Christopher Holden Henry 1101 Chestnut St	$46.61	12	12
Fadi William Mikhail 3400 Spruce St	$104.23	12	12
Autumn B Cohen 1427 Vine St	$25.44	12	12
Christopher James Farrell 909 Walnut St	$29.80	12	12
Pablo Laje 34Th & Civic Center Blvd	$114.90	12	12
Scott G. Hubosky 833 Chestnut St	$28.00	12	12
Robert M Kotloff 3400 Spruce Street	$44.47	12	12
Michael S Sherman 219 N Broad St	$0.10	12	12
Matthew Jenkins 3401 N Broad St	$24.62	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)