Average Medicaid Office Visit Payments in Somerville, TN: $28.88
Avg. Paid
$28.88
Range
$13.58 – $45.48
Total Claims
128,689
Providers
13
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 Somerville, TN
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Kristy L Daniels
16530 Us Highway 64 |
$43.24 | 244 | 236 |
|
Carolyn Adrienne Ayler
12995 Us Highway 64 |
$24.20 | 249 | 182 |
|
Jessica Nicole Ross
16530 Us Highway 64 |
$15.28 | 501 | 285 |
|
Stephanie Denise Smith
308 Lake Dr |
$24.10 | 769 | 499 |
|
David Miedema
25 Woodbridge Rd Ste A |
$33.74 | 1,673 | 1,303 |
|
Pamela C Pierski
17310 Hwy 64 |
$26.81 | 3,993 | 3,379 |
|
Karl Byington Rhea
17310 Hwy 64 |
$14.20 | 4,650 | 3,558 |
|
Paul E Scates
12995 Highway 64 |
$31.27 | 4,845 | 4,052 |
|
Jamey K Colston
25 Woodbridge Rd |
$26.44 | 6,358 | 5,288 |
|
John Elijah Bell
305 Lake Dr |
$13.58 | 13,354 | 7,551 |
|
Raymond Hawkins
25 Woodbridge Rd Ste A |
$37.59 | 18,520 | 15,208 |
|
Derrick R Hamilton
214 Lakeview Rd |
$45.48 | 35,797 | 29,002 |
|
David L Seaton
16532 Us Highway 64 |
$16.40 | 37,736 | 23,317 |
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 Somerville, TN?
Based on public Medicaid payment data, the average Medicaid reimbursement for Office Visit in Somerville, TN is $28.88 per claim, based on 128,689 claims from 13 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 Somerville, TN?
There are 13 Medicaid providers offering Office Visit related services in Somerville, TN according to public payment data.
What is the price range for Office Visit in Somerville, TN?
Medicaid reimbursement for Office Visit in Somerville, TN ranges from $13.58 to $45.48 per claim, with an average of $28.88. 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 Somerville, TN
Vaccines & Immunizations
Avg $17.17
35,949 claims
Blood Work & Lab Tests
Avg $3.64
32,910 claims
Podiatry (Foot Care)
Avg $4.62
27,484 claims
Ambulance Transport
Avg $67.64
22,159 claims
Urinalysis & Urine Tests
Avg $1.54
21,071 claims
Eye Exam
Avg $20.97
9,843 claims
Hearing Test (Audiometry)
Avg $7.28
8,458 claims
Prescription Medications
Avg $4.87
5,342 claims