Average Medicaid Office Visit Payments in Pottstown, PA: $39.94
Avg. Paid
$39.94
Range
$0.00 – $111.65
Total Claims
96,350
Providers
88
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 Pottstown, PA
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Ilias M Almakaev
351 W Schuylkill Rd Ste G-15A |
$96.46 | 12,981 | 8,130 |
|
Lisa Anne Johnson
1600 E High St |
$34.70 | 7,113 | 6,094 |
|
Charlyce J Wallington
800 Heritage Dr Ste 820 |
$60.68 | 4,437 | 4,228 |
|
William Allen Haug
11 Robinson Street |
$0.02 | 4,384 | 4,069 |
|
Manjula Kandaa Raman
13 Armand Hammer Blvd |
$20.78 | 3,338 | 3,132 |
|
Jacek Zdzislaw Obara
11 Robinson St Ste 100 |
$0.07 | 3,295 | 3,001 |
|
Collette Hain
351 W Schuylkill Rd Ste G-15A |
$0.02 | 3,209 | 2,983 |
|
Thomas Raymond Haley
1603 E High St |
$28.13 | 3,146 | 2,846 |
|
Erin Kathryn Woltjen
250 Pearl St |
$0.27 | 2,789 | 2,619 |
|
Sarah Spengler
351 W Schuylkill Rd Ste G-15A |
$1.67 | 2,730 | 2,522 |
|
Natalia Alycia Massias
351 W Schuylkill Rd Ste G-15A |
$0.26 | 2,463 | 2,270 |
|
Krista Marie Dankiw-Ludwig
351 W Schuylkill Rd Ste G-15A |
$0.30 | 2,420 | 2,104 |
|
Kalyani Narra
1600 E High St |
$44.17 | 1,939 | 1,777 |
|
Dorota Kaminski
1590 Medical Dr |
$63.79 | 1,863 | 1,759 |
|
Mary Dressler-Carre
351 W Schuylkill Rd Ste G-15A |
$38.73 | 1,862 | 1,800 |
|
Christiopher Charles Dankmyer
1603 E High St |
$28.99 | 1,776 | 1,669 |
|
James T Guille
1561 Medical Dr. |
$111.65 | 1,699 | 1,618 |
|
Noah A Bass
1600 E High St |
$38.00 | 1,607 | 1,367 |
|
Charles V Touey
1597 Medical Dr |
$62.25 | 1,577 | 1,222 |
|
Simon Sarkis Boulattouf
119 Shoemaker Rd |
$24.56 | 1,441 | 1,265 |
|
Karen Smith Bigelow
1590 Medical Drive |
$69.16 | 1,371 | 1,324 |
|
David Lloyd Lichten
1603 E High St |
$30.28 | 1,332 | 1,256 |
|
Kirstin A Tarquini
351 W Schuylkill Rd Ste G15A |
$64.37 | 1,301 | 1,099 |
|
Jessica Nancy Williams
1610 Medical Dr |
$63.96 | 1,252 | 1,123 |
|
Claire B Olstad
1610 Medical Dr |
$63.64 | 1,216 | 1,174 |
|
Ashleigh Clair Sobotka
800 Heritage Dr |
$59.97 | 1,176 | 1,117 |
|
An H Pham
1591 Medical Dr |
$21.05 | 1,175 | 1,096 |
|
Dena Caplan
800 Heritage Dr |
$49.19 | 1,099 | 1,065 |
|
Neliza Jane Lao
351 W Schuylkill Rd Ste G-15A |
$0.19 | 1,044 | 968 |
|
Deborah A Young
730 S Hanover St |
$47.31 | 920 | 896 |
|
Scott Eric Drobnis
119 Shoemaker Rd |
$40.79 | 913 | 874 |
|
Elisa K Ross
1597 Medical Dr |
$15.36 | 902 | 664 |
|
Pottstown Clinic Company Llc
730 S Hanover St |
$40.12 | 852 | 740 |
|
Krysten Varano
800 Heritage Dr |
$56.06 | 846 | 814 |
|
Yardlie Toussaint-Foster
1590 Medical Dr Ste A |
$4.34 | 822 | 769 |
|
Kanica Yashi
1600 E High St |
$34.24 | 799 | 747 |
|
Maria Conwell
1590 Medical Drive |
$44.09 | 766 | 754 |
|
Danielle Parks
351 W Schuylkill Rd Ste G-15A |
$0.11 | 710 | 636 |
|
Irene Shepherd
351 W Schuylkill Rd |
$0.00 | 693 | 645 |
|
Sergio R Vaisman
1591 Medical Dr |
$1.20 | 675 | 655 |
|
Gabriella Pugliese
1610 Medical Dr Ste 105 |
$61.85 | 625 | 535 |
|
Christine Campbell
1597 Medical Dr |
$62.06 | 612 | 555 |
|
Michelle Lynn Hurst
1597 Medical Dr |
$61.54 | 594 | 529 |
|
Glenn E Lipton
1561 Medical Drive |
$86.73 | 586 | 550 |
|
Joseph Stephen Demidovich
1569 Medical Dr Ste 202 |
$36.12 | 585 | 578 |
|
Charles F. Gorey
730 S Hanover St |
$52.44 | 572 | 564 |
|
Richard Saunders
13 Armand Hammer Blvd Ste 100 |
$37.34 | 504 | 483 |
|
Ronald L Swaab
1591 Medical Dr |
$34.60 | 455 | 422 |
|
Community Health And Dental Care, Inc
351 W Schuylkill Rd |
$5.45 | 417 | 294 |
|
Nyeemah Kennedy
351 W Schuylkill Rd Ste G-15A |
$0.00 | 395 | 348 |
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 Pottstown, PA?
Based on public Medicaid payment data, the average Medicaid reimbursement for Office Visit in Pottstown, PA is $39.94 per claim, based on 96,350 claims from 88 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 Pottstown, PA?
There are 88 Medicaid providers offering Office Visit related services in Pottstown, PA according to public payment data.
What is the price range for Office Visit in Pottstown, PA?
Medicaid reimbursement for Office Visit in Pottstown, PA ranges from $0.00 to $111.65 per claim, with an average of $39.94. 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 Pottstown, PA
Physical Therapy
Avg $25.52
53,510 claims
Home Health Visit
Avg $94.65
40,094 claims
Speech Therapy
Avg $25.18
38,459 claims
Ambulance Transport
Avg $55.29
37,007 claims
Emergency Room Visit
Avg $110.51
33,179 claims
Vaccines & Immunizations
Avg $5.02
20,875 claims
Dental Cleaning & Exam
Avg $12.40
16,066 claims
Blood Work & Lab Tests
Avg $7.59
13,844 claims