Average Medicaid Office Visit Payments in Shelby, OH: $30.11
Avg. Paid
$30.11
Range
$0.00 – $134.50
Total Claims
35,597
Providers
18
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 Shelby, OH
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Third Street Community Clinic Inc
199 W Main St |
$0.00 | 15 | 12 |
|
Lisa A Vousden
110 Auburn Ave |
$134.50 | 16 | 15 |
|
Lannette A Clemons
24 Morris Rd Ste 2 |
$26.48 | 27 | 26 |
|
Philip Ronald Zitko
76 W Main St |
$65.17 | 68 | 64 |
|
Monica Gupta
24 E Whitney Ave |
$65.56 | 115 | 104 |
|
Stephnie Darby
2775 State Route 39 |
$18.41 | 121 | 16 |
|
John Ronald Creighton
199 W Main St Ste 2100 |
$53.80 | 164 | 141 |
|
Ajay Chawla
110 Auburn Ave |
$6.25 | 460 | 384 |
|
Mark C Leeson
24 Morris Rd |
$28.02 | 561 | 529 |
|
Jamie Linn Ladd
24 E Whitney Ave |
$42.11 | 644 | 584 |
|
Kevin Paul Mcgarvey
110 W Smiley Ave |
$28.54 | 876 | 689 |
|
Third Street Community Clinic Inc
31 E Main St |
$0.36 | 1,164 | 856 |
|
Marion C Demers
24 E Whitney Ave |
$41.45 | 1,263 | 1,143 |
|
Omar F S Guimaraes
24 Morris Road |
$37.11 | 1,430 | 926 |
|
Amanda Michelle Mcaleer
199 W Main St |
$46.73 | 2,883 | 2,399 |
|
Joseph Jay Guth
24 Morris Rd |
$30.27 | 3,611 | 3,440 |
|
Megan Lynn Oberhauser
24 E Whitney Ave |
$52.53 | 3,755 | 3,597 |
|
David J Etzel
31 E Main St |
$23.23 | 18,424 | 10,308 |
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 Shelby, OH?
Based on public Medicaid payment data, the average Medicaid reimbursement for Office Visit in Shelby, OH is $30.11 per claim, based on 35,597 claims from 18 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 Shelby, OH?
There are 18 Medicaid providers offering Office Visit related services in Shelby, OH according to public payment data.
What is the price range for Office Visit in Shelby, OH?
Medicaid reimbursement for Office Visit in Shelby, OH ranges from $0.00 to $134.50 per claim, with an average of $30.11. 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 Shelby, OH
Substance Abuse Treatment
Avg $176.63
128,629 claims
Behavioral & Mental Health Therapy
Avg $104.32
29,967 claims
Psychiatric Evaluation
Avg $64.93
29,094 claims
Nursing Facility Care
Avg $9.27
12,198 claims
Dental Cleaning & Exam
Avg $13.56
10,144 claims
Eye Exam
Avg $19.64
9,789 claims
Physical Therapy
Avg $14.44
9,536 claims
Speech Therapy
Avg $33.02
7,479 claims