Based on public Medicaid payment data.

Average Medicaid Office Visit Payments in Rochester, NY: $80.81

Avg. Paid

$80.81

Range

$0.00 – $532.82

Total Claims

3,372,720

Providers

2,362

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 Rochester, NY

Provider	Avg. Paid	Claims	Patients
Rochester General Hospital 1425 Portland Ave	$129.69	194,266	176,502
University Of Rochester 601 Elmwood Ave	$129.26	159,718	150,887
The Unity Hospital Of Rochester 1555 Long Pond Rd	$128.08	64,001	57,054
U Of R Neurology Department 601 Elmwood Ave	$185.02	45,450	42,371
Planned Parenthood Of Central And Western New York, Inc 114 University Ave	$153.60	39,114	38,082
Meenu Mittal Jindal 601 Elmwood Ave # 632B	$43.31	27,845	24,897
Fatma Akmese 293 Upper Falls Blvd	$59.24	22,797	20,459
Robert L Weisman 601 Elmwood Ave	$149.84	22,274	13,671
The Unity Hospital Of Rochester 81 Lake Ave	$123.37	22,060	17,274
Pierre Maxime Jean Charles 293 Upper Falls Blvd	$67.39	19,566	18,265
Resika Ubayawardena 222 Alexander St, Ste 5000	$70.50	17,892	16,001
The Unity Hospital Of Rochester 81 Lake Ave	$122.41	17,821	17,255
Matthew D Mack 340 Arnett Blvd	$60.07	17,762	10,968
Sarah Akram Janjua 1425 Portland Ave	$63.39	17,074	15,988
Nidun Daniel 222 Alexander St	$73.66	15,455	13,758
Mohamad Mahmoud 100 Kings Hwy S	$61.45	15,275	14,259
Catholic Charities Of The Diocese Of Rochester 79 N Clinton Ave	$102.63	14,856	13,992
Kellie Lipsey Reed 158 Orchard St	$55.34	14,848	9,460
Matthew Brown 55 Genesee St	$49.55	14,790	10,799
Kevin George O'Gara 1800 English Rd Ste 10	$79.42	14,774	14,003
Katie Goonan Sussman 222 Alexander St	$66.12	14,527	14,020
Syed Siraj Masood 1295 Portland Ave	$79.55	14,462	13,213
Tai Nguyen 222 Alexander St	$60.72	14,336	13,548
Charles Ippolito 222 Alexander St	$58.25	13,524	12,316
Sarah Jane Bolduc 89 Genesee St	$83.91	12,549	8,665
Laura Henrichs Cardella 315 Science Pkwy	$143.26	12,422	7,581
Valerie Maria Rozak Brunson 1425 Portland Avenue	$63.25	12,080	11,785
Huther-Doyle Memorial Institute Inc 360 East Ave	$113.82	11,654	7,922
Soon-Il Song 82 Holland St	$63.74	11,434	9,135
Seth Christopher Jacob-Wagner 114 University Ave	$46.69	10,740	5,688
Elder One 2066 Hudson Ave	$0.00	10,458	4,304
Conifer Park, Inc. 556 Clinton Ave S	$102.39	10,434	5,299
Douglas L Stockman 777 Clinton Ave S	$73.11	10,252	9,931
Cassandra Jolin 158 Orchard St	$59.60	10,039	6,839
Jacob Dominik 755 Jefferson Rd	$76.17	10,009	9,965
Nashat S. Atalla 82 Holland Street	$67.67	9,962	6,430
Shazia Janmuhammad 1425 Portland Avenue	$54.22	9,855	7,922
Branko Matich 322 Lake Ave	$30.51	9,839	7,377
Roger Joseph Chapman 82 Holland St	$54.27	9,824	7,293
Christopher Michael Henderson 1425 Portland Ave	$46.38	9,502	9,118
Pradip R Kadakia 1425 Portland Ave	$67.34	9,463	8,775
Douglas Liano 65 Genesee St Fl 1	$60.64	9,434	7,823
Andrew Lang 293 Upper Falls Blvd	$70.89	9,418	8,524
Villa Of Hope 3300 Dewey Ave	$98.67	9,347	7,789
Karol Hyjek 1425 Portland Ave	$62.92	9,272	8,917
Behavioral Health Network, Inc. 490 Ridge Rd E	$97.68	9,228	9,065
Ammar Alkassm 1425 Portland Ave	$54.92	9,080	8,472
Ruvim Falkovich 1425 Portland Ave	$68.02	9,073	8,417
Heidi Witmer Smith 1425 Portland Ave	$63.33	8,997	8,623
Paul Lehoullier 1425 Portland Ave	$60.63	8,875	8,745

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 Rochester, NY?

Based on public Medicaid payment data, the average Medicaid reimbursement for Office Visit in Rochester, NY is $80.81 per claim, based on 3,372,720 claims from 2362 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 Rochester, NY?

There are 2362 Medicaid providers offering Office Visit related services in Rochester, NY according to public payment data.

What is the price range for Office Visit in Rochester, NY?

Medicaid reimbursement for Office Visit in Rochester, NY ranges from $0.00 to $532.82 per claim, with an average of $80.81. Private insurance and self-pay costs are typically higher than these Medicaid rates.

Average Medicaid Office Visit Payments in Rochester, NY: $80.81

Providers Offering Office Visit in Rochester, NY

What to Expect: Office Visit

Cost Components

Frequently Asked Questions

Office Visit in Other Cities

Brooklyn, NY

New York, NY

Los Angeles, CA

Chicago, IL

Bronx, NY

Phoenix, AZ

Houston, TX

Las Vegas, NV

Other Procedures in Rochester, NY

Home Health Visit

Blood Work & Lab Tests

Emergency Room Visit

Case Management Services

Psychiatric Evaluation

Substance Abuse Treatment

Physical Therapy

Ambulance Transport