Average Medicaid Office Visit Payments in Philipsburg, PA: $20.96
Avg. Paid
$20.96
Range
$0.00 – $223.37
Total Claims
38,728
Providers
21
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 Philipsburg, PA
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Brookville Hospital
271 Railroad St |
$0.57 | 16,043 | 15,063 |
|
Jennifer L Graham
210 Medical Center Dr. |
$40.80 | 3,426 | 3,160 |
|
Philip A. Pilgram
210 Medical Center Dr |
$40.09 | 3,341 | 3,167 |
|
Adam Daniel Paronish
18 N Front St |
$32.16 | 3,340 | 3,176 |
|
Samantha Neuwirth
18 N Front St |
$19.29 | 2,040 | 1,926 |
|
Diana Dawn Dutra
210 Medical Center Dr |
$39.40 | 1,921 | 1,744 |
|
Melissa Michael
601 N Front St |
$0.10 | 1,506 | 1,454 |
|
Tiffany Cragan
18 N Front St |
$35.24 | 1,499 | 1,432 |
|
Kelly Snyder
18 N Front St |
$42.79 | 1,053 | 999 |
|
Aretta Straw
18 N Front St |
$20.51 | 855 | 797 |
|
Caring Healthcare Network
18 N Front St |
$1.68 | 845 | 732 |
|
Kathleen A. Schaefer
210 Medical Center Dr |
$40.78 | 747 | 738 |
|
Amanda Mae Olson
210 Medical Center Dr |
$41.72 | 621 | 560 |
|
Doriann Lee Lavery
210 Medical Center Dr |
$42.78 | 607 | 585 |
|
Lucas Wade Irwin
1061 N Front St Ste 2 |
$223.37 | 425 | 354 |
|
Coulton Casteel
210 E Locust St # 248 |
$30.56 | 174 | 170 |
|
Charles W. Maxin
210 Medical Center Dr |
$29.84 | 122 | 113 |
|
Brandon David Swisher
601 N Front St |
$0.00 | 94 | 92 |
|
Gloria Zibilich
1049 N Front St |
$60.70 | 39 | 39 |
|
Jared Maurer
1061 N Front St Ste 2 |
$55.21 | 15 | 14 |
|
Akinola Mobolaji
220 N Front St |
$0.00 | 15 | 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 Philipsburg, PA?
Based on public Medicaid payment data, the average Medicaid reimbursement for Office Visit in Philipsburg, PA is $20.96 per claim, based on 38,728 claims from 21 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 Philipsburg, PA?
There are 21 Medicaid providers offering Office Visit related services in Philipsburg, PA according to public payment data.
What is the price range for Office Visit in Philipsburg, PA?
Medicaid reimbursement for Office Visit in Philipsburg, PA ranges from $0.00 to $223.37 per claim, with an average of $20.96. 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 Philipsburg, PA
Speech Therapy
Avg $22.90
53,441 claims
Ambulance Transport
Avg $22.39
34,918 claims
Physical Therapy
Avg $29.47
34,221 claims
Chiropractic Care
Avg $10.91
32,022 claims
Home Health Visit
Avg $70.09
8,699 claims
Durable Medical Equipment (DME)
Avg $29.44
3,232 claims
Psychiatric Evaluation
Avg $47.76
1,320 claims
Blood Work & Lab Tests
Avg $9.19
1,063 claims