Average Medicaid Office Visit Payments in Portland, ME: $36.14
Avg. Paid
$36.14
Range
$0.00 – $138.35
Total Claims
593,977
Providers
640
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 Portland, ME
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Portland Community Health Center
180 Park Ave |
$7.00 | 41,317 | 34,816 |
|
Portland Community Health Center
63 Preble St |
$9.77 | 29,432 | 19,634 |
|
Mercy Hospital
175 Fore River Pkwy |
$35.82 | 9,622 | 7,918 |
|
Ann Salisbury
144 State St |
$88.95 | 8,747 | 8,371 |
|
Jill Husson Martinez
216 Vaughan St |
$13.82 | 8,276 | 5,627 |
|
Yana R Wirengard
22 Bramhall St |
$0.00 | 7,664 | 4,267 |
|
Ryan Joseph Hiebert
51 Sewall St Ste 2 |
$30.13 | 6,073 | 4,935 |
|
Carrie Frost
180 Park Ave |
$41.20 | 5,507 | 5,060 |
|
Portland Community Health Center
934 Congress St |
$9.80 | 5,467 | 1,532 |
|
James A Katz
144 State St |
$23.45 | 5,236 | 4,933 |
|
Caroline Joy Wilmot
84 Marginal Way |
$64.40 | 5,204 | 4,561 |
|
Sadie Jennings Knott
50 Monument Sq |
$44.88 | 5,009 | 3,392 |
|
Jeffrey J Bean
335 Brighton Ave Ste 200 |
$36.51 | 4,690 | 4,284 |
|
John Dolan
84 Marginal Way Ste 700 |
$29.37 | 4,389 | 4,287 |
|
Leah K Bauer
216 Vaughan St |
$23.03 | 4,387 | 2,919 |
|
Kristin Ricci
22 Bramhall St |
$35.63 | 4,334 | 3,594 |
|
Tamiko N Davies
22 Bramhall St |
$36.40 | 4,294 | 3,659 |
|
Jennifer D Mora
22 Bramhall St |
$39.58 | 4,186 | 3,864 |
|
Victoria P Dalzell
1577 Congress St |
$66.59 | 4,184 | 4,058 |
|
Portland Community Health Center
59 Riverton Dr |
$3.98 | 4,159 | 3,582 |
|
Megan Lynne Black
43 Baxter Blvd |
$32.38 | 4,157 | 3,906 |
|
Donna Lynne Greenwood
43 Baxter Blvd |
$21.95 | 3,797 | 3,570 |
|
Genevieve D. Mack
84 Marginal Way Ste 1000 |
$65.36 | 3,635 | 2,963 |
|
Kristen B Silvia
576 Saint John St |
$38.39 | 3,607 | 2,625 |
|
Rushika M Conroy
41 Donald B Dean Dr Ste A |
$80.32 | 3,600 | 3,555 |
|
Rosalind Gold
216 Vaughan St |
$34.28 | 3,547 | 3,299 |
|
Christopher B Murry
1250 Forest Ave |
$53.88 | 3,539 | 3,475 |
|
Portland Community Health Center
295 Park Ave |
$12.53 | 3,520 | 3,296 |
|
Robert Kysela
22 Bramhall St |
$28.14 | 3,502 | 2,913 |
|
Tiney Elizabeth Ray
400 Congress St Ste 300 |
$18.82 | 3,483 | 2,229 |
|
Jeffrey D Schoengold
22 Bramhall St |
$58.63 | 3,390 | 3,237 |
|
Carol L Hubbard
1577 Congress St |
$73.63 | 3,380 | 3,260 |
|
John Tweed
932 Congress St |
$56.98 | 3,306 | 3,167 |
|
Dale Taper Harrison
272 Congress St |
$30.58 | 3,300 | 3,060 |
|
Ingrid E Martin
272 Congress Street |
$30.72 | 3,282 | 3,077 |
|
Benjamin Felix
22 Bramhall St |
$35.94 | 3,271 | 3,132 |
|
Gretchen A. Pianka
180 Park Ave Ste 1 |
$35.61 | 3,252 | 3,046 |
|
Elizabeth Rayann Linnell
887 Congress St Ste 200 |
$27.40 | 3,196 | 2,220 |
|
Michele L Rock
1577 Congress St |
$57.95 | 3,195 | 2,991 |
|
Stephen Maturo
1250 Forest Ave Ste 301 |
$51.49 | 3,169 | 3,071 |
|
Portland Community Health Center
284 Cumberland Ave |
$2.65 | 3,100 | 2,833 |
|
Catherine S Curry
1577 Congress St |
$40.15 | 2,983 | 2,783 |
|
Lindsey Clement
272 Congress St |
$35.85 | 2,943 | 2,816 |
|
Katheryn Baden
716 Stevens Ave |
$42.07 | 2,904 | 2,863 |
|
Amy P Farb
295 Forest Ave |
$75.81 | 2,902 | 2,647 |
|
Allyson Rebecca Hornstein
22 Bramhall St |
$40.31 | 2,823 | 2,390 |
|
Kristen Knopp
1145 Brighton Ave |
$23.34 | 2,804 | 2,667 |
|
Julia Brock
22 Bramhall St |
$33.29 | 2,777 | 2,551 |
|
Ariel Porterfield Zodhiates
180 Park Ave Ste 1 |
$4.68 | 2,774 | 1,738 |
|
Peggy Cyr
272 Congress St |
$36.59 | 2,769 | 2,571 |
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 Portland, ME?
Based on public Medicaid payment data, the average Medicaid reimbursement for Office Visit in Portland, ME is $36.14 per claim, based on 593,977 claims from 640 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 Portland, ME?
There are 640 Medicaid providers offering Office Visit related services in Portland, ME according to public payment data.
What is the price range for Office Visit in Portland, ME?
Medicaid reimbursement for Office Visit in Portland, ME ranges from $0.00 to $138.35 per claim, with an average of $36.14. 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 Portland, ME
Blood Work & Lab Tests
Avg $1.50
622,485 claims
Home Health Visit
Avg $319.11
499,937 claims
Case Management Services
Avg $67.60
459,038 claims
Substance Abuse Treatment
Avg $116.83
397,924 claims
Emergency Room Visit
Avg $145.93
357,964 claims
X-Ray
Avg $10.50
304,258 claims
Behavioral & Mental Health Therapy
Avg $199.04
231,478 claims
Ultrasound
Avg $41.00
223,352 claims