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 |
|---|---|---|---|
|
Christina Thanh Bach
1561 Long Pond Rd Ste 408 |
$173.97 | 12 | 12 |
|
Manoj Jacob Mammen
601 Elmwood Ave. |
$10.83 | 12 | 12 |
|
Anca Seger
2000 Winton Rd S |
$66.41 | 12 | 12 |
|
Steven Bruce Fishberger
601 Elmwood Ave |
$76.20 | 12 | 12 |
|
Andrew M Wensel
1445 Portland Ave |
$131.82 | 12 | 12 |
|
Daniel Chun
601 Elmwood Ave |
$116.36 | 12 | 12 |
|
Ronald Schwartz
601 Elmwood Ave |
$115.80 | 12 | 12 |
|
Dasha Moza
1425 Portland Ave; Wilson Building |
$89.83 | 12 | 12 |
|
Brandon Scott Sprung
601 Elmwood Ave |
$97.08 | 12 | 12 |
|
Anna-Claire Marrone
601 Elmwood Ave |
$151.77 | 12 | 12 |
|
Lindy Marie Pescosolido
601 Elmwood Ave |
$69.92 | 12 | 12 |
|
David Quinzi
601 Elmwood Ave |
$91.98 | 12 | 12 |
|
Lara B Evans
995 Senator Keating Blvd |
$96.92 | 12 | 12 |
|
Kimberly M Fitch
601 Elmwood Ave |
$86.36 | 12 | 12 |
|
Diana F Curcio-Abou
2261 Monroe Ave |
$70.82 | 12 | 12 |
|
Karin Gaul
300 Meridian Centre Blvd |
$54.43 | 12 | 12 |
|
Deena Marie Wisa
60 Greece Center Dr Ste 4 |
$68.95 | 12 | 12 |
|
Derek Steven Wakeman
601 Elmwood Ave |
$159.45 | 12 | 12 |
|
Prasadvarma Penmetsa
1561 Long Pond Rd |
$41.99 | 12 | 12 |
|
Erdal S Erturk
601 Elmwood Ave |
$65.60 | 12 | 12 |
|
Colin Michael Mchugh
1000 South Ave Bldg Level3 |
$62.33 | 12 | 12 |
|
Judith Simmons Neuderfer
1425 Portland Ave |
$53.19 | 12 | 12 |
|
Kathryn A Comella
2400 S Clinton Ave Bldg F |
$87.77 | 12 | 12 |
|
Mary Jo Lavilla
601 Elmwood Ave |
$62.31 | 12 | 12 |
|
Zaid Saeed
490 E Ridge Rd |
$42.82 | 12 | 12 |
|
Jonathan Redditt
1455 E Ridge Rd |
$53.60 | 12 | 12 |
|
Alok D Gandhi
1415Portland Ave |
$37.03 | 12 | 12 |
|
Matthew James St.John
601 Elmwood Ave |
$137.73 | 12 | 12 |
|
Stacy Sun
125 Lattimore Rd Ste 200 |
$73.13 | 12 | 12 |
|
Wendy T Cheruiyot
601 Elmwood Ave |
$113.62 | 12 | 12 |
|
Michael D Depaolis
169 Rue De Vl |
$70.37 | 12 | 12 |
|
Lorraine Cleary
25 Wayne Dr |
$80.25 | 12 | 12 |
|
Michael C. Kallay
1000 South Ave |
$28.51 | 12 | 12 |
|
Raissa Villanueva
919 Westfall Rd |
$16.69 | 12 | 12 |
|
Angelina Winbush
601 Elmwood Ave |
$77.45 | 12 | 12 |
|
Sean Cole
600 Red Creek Dr Ste 200 |
$48.20 | 12 | 12 |
|
John Schriefer
601 Elmwood Ave |
$24.85 | 12 | 12 |
|
Yousuf Khalifa
601 Elmwood Ave |
$67.33 | 12 | 12 |
|
Colin Donahoe
180 Sawgrass Dr Ste 230 |
$83.83 | 12 | 12 |
|
Megan Barbato
601 Elmwood Ave |
$54.54 | 12 | 12 |
|
Marvin Singh
20 Hagen Dr Ste 330 |
$84.97 | 12 | 12 |
|
Selvakumar Chockalingam
1400 Portland Ave |
$22.92 | 12 | 12 |
|
Bradley James Hensley
360 Linden Oaks Ste 300 |
$89.13 | 12 | 12 |
|
Jennifer Stenglein
2619 Culver Rd |
$49.62 | 12 | 12 |
|
Ted Louie
601 Elmwood Ave |
$34.44 | 12 | 12 |
|
Delphi Hospitalist Services Llc
1160 Chili Ave Ste 200 |
$3.12 | 12 | 12 |
|
Iga Ntheketha
125 Lattimore Rd Ste G110 |
$146.30 | 12 | 12 |
|
Vivek Kaul
601 Elmwood Ave |
$22.07 | 12 | 12 |
|
West Ridge Obstetrics And Gynecology, Llp
3101 Ridge Rd W |
$59.10 | 12 | 12 |
|
Gerald M Gacioch
30 Hagen Dr |
$31.28 | 12 | 12 |
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.
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 Rochester, NY
Home Health Visit
Avg $155.96
4,468,559 claims
Blood Work & Lab Tests
Avg $13.58
3,406,771 claims
Emergency Room Visit
Avg $129.50
1,243,277 claims
Case Management Services
Avg $416.23
1,188,020 claims
Psychiatric Evaluation
Avg $142.49
1,087,559 claims
Substance Abuse Treatment
Avg $66.55
788,422 claims
Physical Therapy
Avg $59.14
727,107 claims
Ambulance Transport
Avg $103.20
693,655 claims