Average Medicaid Office Visit Payments in Pikeville, TN: $34.96
Avg. Paid
$34.96
Range
$23.90 – $54.79
Total Claims
71,901
Providers
17
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 Pikeville, TN
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Amie Sims Rainey
3062 Main St |
$30.36 | 9,432 | 7,345 |
|
Desiree Cadell Brock-Hudson
3062 Main St |
$29.12 | 8,775 | 6,831 |
|
Jennifer Suzanne Alvarez
136 Wheelertown Ave |
$50.44 | 7,250 | 6,366 |
|
Julie Mae Brewer
3625 Main St |
$34.03 | 6,489 | 5,545 |
|
Ruth Ellen Boynton
3062 Main St |
$28.28 | 6,266 | 4,963 |
|
Fredrick S Dibrell
136 Wheelertown Avenue |
$25.88 | 5,863 | 4,678 |
|
Larry Bruce Compton
344 Church St |
$26.51 | 5,550 | 4,149 |
|
Alexandra Pendergrass
136 Wheelertown Ave |
$42.06 | 5,485 | 4,809 |
|
Debora Joan Angel-Pompi
232 Cleveland Ave |
$34.71 | 3,886 | 2,879 |
|
Sonja Renfroe
344 Church St. |
$54.79 | 3,695 | 3,236 |
|
Tiffany Danielle Turner
344 Church St |
$23.90 | 3,091 | 2,127 |
|
Meghan Weaver
3625 Main St |
$53.17 | 1,649 | 1,511 |
|
Pikeville Urgent Care, Pllc
344 Church St. |
$32.66 | 1,468 | 804 |
|
Ryan Litchfield
344 Church St |
$53.46 | 1,147 | 925 |
|
Diana Tapu Sanders
136 Wheelertown Ave |
$36.65 | 1,002 | 869 |
|
Pikeville Clinic, Llc
3062 Main St |
$37.93 | 728 | 499 |
|
Ashley Mae Tibbetts
3625 Main St |
$49.78 | 125 | 109 |
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 Pikeville, TN?
Based on public Medicaid payment data, the average Medicaid reimbursement for Office Visit in Pikeville, TN is $34.96 per claim, based on 71,901 claims from 17 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 Pikeville, TN?
There are 17 Medicaid providers offering Office Visit related services in Pikeville, TN according to public payment data.
What is the price range for Office Visit in Pikeville, TN?
Medicaid reimbursement for Office Visit in Pikeville, TN ranges from $23.90 to $54.79 per claim, with an average of $34.96. 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 Pikeville, TN
Blood Work & Lab Tests
Avg $3.38
15,702 claims
Ambulance Transport
Avg $50.72
9,484 claims
Dental Cleaning & Exam
Avg $30.68
7,911 claims
Vaccines & Immunizations
Avg $12.53
7,565 claims
Dental Filling
Avg $67.61
3,140 claims
Psychiatric Evaluation
Avg $26.94
3,034 claims
Speech Therapy
Avg $11.50
2,521 claims
Emergency Room Visit
Avg $62.45
1,981 claims