Average Medicaid Office Visit Payments in Pineville, KY: $33.60
Avg. Paid
$33.60
Range
$6.30 – $47.16
Total Claims
281,854
Providers
33
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 Pineville, KY
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Terry David Pannell
12904 Robert L Madon Byp Ste 2 |
$25.40 | 35 | 30 |
|
Pineville Community Health Center Inc
850 Riverview Ave |
$6.30 | 62 | 28 |
|
Jennie Katelyn Nolan
222 W Tennessee Ave |
$22.75 | 173 | 146 |
|
Brooke Norris
251 S Pine St |
$24.91 | 187 | 93 |
|
Pineville Er Services
218 E Park Ave |
$25.08 | 248 | 216 |
|
Jessica L Mills
850 Riverview Ave |
$16.80 | 337 | 207 |
|
Bell County Health Department Inc.
310 S Cherry St |
$33.59 | 793 | 680 |
|
Pineville Community Hospital Association, Inc.
850 Riverview Ave |
$13.35 | 822 | 665 |
|
Whitney Jeree Gann
850 Riverview Ave |
$28.48 | 822 | 756 |
|
Southeast Family Practice Psc
222 W Tennessee Ave |
$19.92 | 825 | 651 |
|
Ashley Langford
39 Ferndale Apartments Rd |
$47.16 | 978 | 894 |
|
Pineville City School
310 S Cherry St |
$38.87 | 1,073 | 473 |
|
Steven Kenneth Morgan
222 E Tennessee Ave |
$38.84 | 1,653 | 1,288 |
|
Nicholas J Dawson Fugate
313 S Cherry St |
$42.72 | 2,513 | 2,133 |
|
Andrea Kaye Miller
313 S Cherry St |
$39.86 | 3,891 | 3,550 |
|
Middlesboro High School
310 S Cherry St |
$39.42 | 4,115 | 2,236 |
|
Mary Catherine Caruso
850 Riverview Rd |
$30.58 | 4,682 | 4,370 |
|
Shawn Shadell Fugate
313 S Cherry St |
$38.69 | 4,949 | 4,141 |
|
Eleanor Liford
850 Riverview Ave |
$28.55 | 6,144 | 5,638 |
|
Amanda Louanne Mills Gann
121 W Virginia Ave |
$18.11 | 6,502 | 4,701 |
|
Pine Mountain Clinic Psc
850 Riverview Rd |
$23.33 | 6,690 | 5,118 |
|
Middlesboro Middle School
310 S Cherry St |
$36.80 | 7,250 | 3,386 |
|
Alice Faye Ward
313 S Cherry St |
$29.29 | 7,430 | 6,329 |
|
Kelly Renee Stewart
850 Riverview Ave. |
$29.68 | 7,790 | 6,695 |
|
Brittany Jean Slone
251 S Pine St |
$16.47 | 8,226 | 5,288 |
|
Trampas S Nolan
222 W Tennessee Ave |
$28.47 | 8,388 | 6,850 |
|
Chasity L King
39 Ferndale Apartments Rd |
$44.23 | 8,944 | 6,389 |
|
Middlesboro Primary School
310 S Cherry St |
$39.10 | 10,115 | 5,896 |
|
Madhan Mohan
850 Riverview Rd |
$39.79 | 11,082 | 10,107 |
|
Martha C Combs-Woolum
251 S Pine St |
$43.50 | 11,325 | 9,214 |
|
Grace Runions
850 Riverview Ave |
$32.58 | 14,340 | 9,965 |
|
Chadwick E Gambrell
121 W Virginia Ave |
$40.84 | 22,124 | 18,916 |
|
Tiffeny Jean Treece
101 Mountain View Cmns |
$32.60 | 117,346 | 61,518 |
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 Pineville, KY?
Based on public Medicaid payment data, the average Medicaid reimbursement for Office Visit in Pineville, KY is $33.60 per claim, based on 281,854 claims from 33 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 Pineville, KY?
There are 33 Medicaid providers offering Office Visit related services in Pineville, KY according to public payment data.
What is the price range for Office Visit in Pineville, KY?
Medicaid reimbursement for Office Visit in Pineville, KY ranges from $6.30 to $47.16 per claim, with an average of $33.60. 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 Pineville, KY
Blood Work & Lab Tests
Avg $6.88
98,339 claims
Nursing Facility Care
Avg $102.42
68,389 claims
X-Ray
Avg $13.13
22,369 claims
Emergency Room Visit
Avg $124.82
21,317 claims
Physical Therapy
Avg $16.94
21,306 claims
Ambulance Transport
Avg $31.11
15,255 claims
Dental Cleaning & Exam
Avg $31.93
13,278 claims
EKG / ECG (Electrocardiogram)
Avg $14.44
12,741 claims