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Based on public Medicaid payment data.

Average Medicaid Office Visit Payments in Sparta, TN: $35.85

Avg. Paid

$35.85

Range

$16.03 – $64.18

Total Claims

109,534

Providers

31

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 Sparta, TN

Provider Avg. Paid Claims Patients
David F Merritt

305 N Spring St

 $25.25 15 13
Shannon Franklin Shelley

25 N Main St

 $18.23 16 12
Kevin Patrick Purgiel

439 Sewell Dr

 $53.12 114 95
Kalyani Medicherla Kumar

411 Sewell Dr

 $43.63 186 169
Sharon Dolorann Lee Hampton

435 Sewell Dr

 $16.59 894 586
Jennifer L Peek

126 E Bockman Way

 $17.43 1,214 1,027
Ryan T Hunley

435 Sewell Dr

 $64.18 1,472 1,323
Alan Ross Drake

287 W Turn Table Rd

 $34.36 1,593 1,263
Robert B Knowles

435 Sewell Dr

 $20.57 1,713 1,319
Amber Nicole Moore

207 E Bockman Way

 $33.25 1,871 1,510
Lee R Boyd

150 Sam Walton Dr Ste 600

 $56.59 1,911 1,741
Chad A Griffin

433 Sewell Dr

 $36.54 1,983 1,727
Diana Jo Turner

457 Vista Dr

 $45.80 2,251 2,039
Mariam Girges

126 E Bockman Way

 $38.90 2,453 2,177
James Clark Childress

457 Vista Dr

 $31.40 2,541 2,059
Linda Stover

457 Vista Dr

 $41.72 2,586 2,191
Jeffrey D Loveland

415 Sewell Dr

 $17.13 2,641 2,413
Laura Allese Snow

150 Sam Walton Dr Ste 600

 $53.02 2,888 2,500
Cameron Wayne Heady

457 Vista Dr

 $29.29 3,318 2,822
Marla J Moore

457 Vista Dr

 $28.98 3,328 2,823
R. Craig Saunders

423 Sewell Dr

 $36.20 3,401 2,678
Mollie Dodson

705 Howell St

 $36.39 4,124 3,474
Robert Francis Baker

207 E Bockman Way

 $16.03 4,813 3,433
Kelly Lyons

433 Sewell Dr

 $35.26 5,151 4,408
Anna V Tylka

433 Sewell Dr

 $35.03 5,270 4,464
Abhay G Kemkar

441 Sewell Rd

 $17.70 6,015 4,709
Elizabeth Rose Scott

150 Sam Walton Dr Ste 600

 $53.24 7,145 6,356
Jeanne Kay Thompson

705 Howell St

 $37.49 8,364 7,092
Ty T Webb

457 Vista Dr

 $28.53 8,990 7,497
Kathleen Loyd

150 Sam Walton Dr

 $54.64 9,956 8,476
Katina England Huff

133 Churchill Dr

 $31.15 11,317 8,689

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 Sparta, TN?

Based on public Medicaid payment data, the average Medicaid reimbursement for Office Visit in Sparta, TN is $35.85 per claim, based on 109,534 claims from 31 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 Sparta, TN?

There are 31 Medicaid providers offering Office Visit related services in Sparta, TN according to public payment data.

What is the price range for Office Visit in Sparta, TN?

Medicaid reimbursement for Office Visit in Sparta, TN ranges from $16.03 to $64.18 per claim, with an average of $35.85. 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 Sparta, TN

Ambulance Transport

Avg $56.00

31,530 claims

X-Ray

Avg $3.84

24,150 claims

Eye Exam

Avg $35.03

21,866 claims

Psychiatric Evaluation

Avg $42.16

20,286 claims

Durable Medical Equipment (DME)

Avg $15.49

11,445 claims

Physical Therapy

Avg $23.41

11,047 claims

Vaccines & Immunizations

Avg $14.04

11,017 claims

CT Scan (Computed Tomography)

Avg $22.34

9,568 claims