Average Medicaid Office Visit Payments in Reading, PA: $40.48
Avg. Paid
$40.48
Range
$0.00 – $290.73
Total Claims
209,225
Providers
143
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 Reading, PA
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Berks Community Health Center
838 Penn St |
$0.19 | 49,984 | 46,486 |
|
Gopalan Sridhar
555 Raymond St |
$42.95 | 12,711 | 11,560 |
|
Matilde R Rodriguez Sotomayor
1220 Centre Ave |
$35.21 | 9,458 | 8,933 |
|
Felipe Antonio Arias
525 Penn St |
$47.10 | 8,223 | 7,782 |
|
Jason Errol Hendrix
2208 Quarry Dr |
$96.20 | 7,731 | 7,607 |
|
Ajay Narendra Jani
838 Penn St |
$46.21 | 7,666 | 7,594 |
|
Niladri Das
145 N 6Th St Fl 2 |
$77.25 | 5,888 | 5,507 |
|
Randy Michael Smargiassi
6 Hearthstone Ct Ste 102 |
$40.90 | 5,713 | 5,521 |
|
Anthony Tomassi
838 Penn St |
$48.52 | 5,246 | 5,186 |
|
Juan Perez
145 N 6Th St Fl 1 |
$65.71 | 4,472 | 4,054 |
|
Gustaw Woch
6 Hearthstone Ct |
$42.09 | 4,335 | 4,103 |
|
Patricia Ann Mcilrath
2808 N 5Th Street Hwy |
$33.30 | 3,549 | 3,452 |
|
Ayesha Wahab
3703 Perkiomen Ave |
$36.31 | 3,496 | 3,458 |
|
Varun Malik
145 N 6Th St |
$65.66 | 3,131 | 2,813 |
|
Fauzia Maqbool
6 Hearthstone Ct |
$43.58 | 3,021 | 2,875 |
|
Noahleen Betts
1741 Perkiomen Ave |
$0.64 | 2,955 | 2,701 |
|
Theresa Erin Yurkonis
2500 Bernville Rd |
$82.40 | 2,740 | 2,630 |
|
Kelly Ann Rexfordhudson
145 N 6Th St |
$106.00 | 2,617 | 2,537 |
|
Vincent Zhang
2494 Bernville Rd Ste 100 |
$74.87 | 2,533 | 2,383 |
|
David C Zobian
6 Hearthstone Ct |
$46.41 | 2,526 | 2,418 |
|
Laura Elizabeth Dewalt
1040 Liggett Ave |
$41.61 | 2,342 | 2,046 |
|
Christina M Scartozzi
145 N 6Th Street |
$70.12 | 2,277 | 2,222 |
|
Christopher Schumacher
2494 Bernville Rd Ste 205 |
$71.48 | 2,043 | 1,969 |
|
Kyle Rompala
420 S 5Th Ave |
$43.18 | 2,036 | 2,016 |
|
Justin Clayton
2494 Bernville Rd |
$39.85 | 1,962 | 1,750 |
|
Joel W Baker
2500 Bernville Rd |
$73.52 | 1,920 | 1,790 |
|
Timothy Andrew Ferenchick
1000 Tuckerton Ct |
$28.19 | 1,853 | 1,796 |
|
Jessika Kissling
2500 Bernville Rd |
$76.16 | 1,851 | 1,745 |
|
Eric Newman
3970 Pekiomen Avenue |
$108.25 | 1,745 | 1,687 |
|
Yali Tu
2494 Bernville Rd Ste 201 |
$25.91 | 1,727 | 1,518 |
|
Jarrod Vincent Drab
145 N 6Th St |
$36.86 | 1,714 | 1,505 |
|
Hridayesh S Nat
3407 N 5Th Street Hwy |
$73.90 | 1,605 | 1,559 |
|
Jorge Bustillo
2494 Bernville Road |
$68.65 | 1,547 | 1,487 |
|
Oumar Sano
110 Rockland St |
$0.29 | 1,429 | 1,306 |
|
Bolaji Abosede Owoloja
951 N 6Th St Ste 221 |
$39.91 | 1,370 | 1,265 |
|
Luciano Migliarino
600 High Blvd |
$41.61 | 1,298 | 1,262 |
|
Hugh Joseph Prentice
600 High Blvd |
$38.24 | 1,183 | 1,072 |
|
Leah Frey
Sixth Avenue And Spruce Street |
$43.66 | 1,127 | 1,093 |
|
Jeannie Stephen
838 Penn St |
$0.67 | 1,087 | 1,053 |
|
Sabrina Elise Turner
145 N 6Th St |
$66.47 | 1,085 | 958 |
|
Margaret G Flores-Posadas
1555 Schuylkill Ave |
$9.60 | 1,049 | 937 |
|
Maria Cristina O Frank
3200 Reading Crest Ave |
$42.30 | 1,006 | 975 |
|
Qaiss Mohammed
2500 Bernville Road |
$51.79 | 1,004 | 839 |
|
Dominic J Cammarano
3701 Perkiomen Ave |
$44.06 | 973 | 897 |
|
Earle Smith Williamson
3970 Perkiomen Ave |
$96.23 | 962 | 942 |
|
Dianne M Mulreaney
120 Prospect St |
$97.23 | 872 | 854 |
|
Barrett Richard
3970 Perkiomen Ave Ste 202 |
$79.33 | 824 | 789 |
|
Viviana Barbosa
555 Raymond St Ste 100 |
$42.50 | 805 | 765 |
|
Marc A Rovito
2494 Bernville Rd |
$62.96 | 767 | 638 |
|
Judith Awurumibe
838 Penn St |
$0.09 | 761 | 726 |
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 Reading, PA?
Based on public Medicaid payment data, the average Medicaid reimbursement for Office Visit in Reading, PA is $40.48 per claim, based on 209,225 claims from 143 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 Reading, PA?
There are 143 Medicaid providers offering Office Visit related services in Reading, PA according to public payment data.
What is the price range for Office Visit in Reading, PA?
Medicaid reimbursement for Office Visit in Reading, PA ranges from $0.00 to $290.73 per claim, with an average of $40.48. 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 Reading, PA
Case Management Services
Avg $92.56
436,319 claims
Physical Therapy
Avg $32.95
123,581 claims
Speech Therapy
Avg $28.47
110,366 claims
Ambulance Transport
Avg $92.36
79,688 claims
Dental Cleaning & Exam
Avg $31.64
56,075 claims
Blood Work & Lab Tests
Avg $9.16
25,412 claims
Durable Medical Equipment (DME)
Avg $37.40
21,867 claims
Vaccines & Immunizations
Avg $5.76
20,412 claims