Average Medicaid Office Visit Payments in Springfield, MA: $71.94
Avg. Paid
$71.94
Range
$0.00 – $446.14
Total Claims
2,654,243
Providers
1,017
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 Springfield, MA
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Baystate Medical Center Inc
759 Chestnut St |
$147.62 | 546,994 | 468,015 |
|
Behavioral Health Network Inc
417 Liberty St |
$51.52 | 76,802 | 72,123 |
|
Center For Human Development, Inc.
332 Birnie Ave |
$88.61 | 45,726 | 43,592 |
|
Behavioral Health Network, Inc
395 Liberty St |
$62.20 | 38,884 | 36,885 |
|
Medexpress Urgent Care, Pc - Massachusetts
430 Cooley St |
$79.35 | 29,599 | 28,875 |
|
Bharati Nandlal Reejhsinghani
754 Chestnut Street |
$66.97 | 27,138 | 19,106 |
|
Gandara Mental Health Center Inc
2155 Main St |
$76.53 | 26,488 | 25,605 |
|
Peter T Demos
125 Liberty St |
$61.12 | 21,684 | 21,292 |
|
Audrey Susan Guhn
380 Plainfield St |
$37.21 | 21,095 | 20,387 |
|
Andrew H Balder
11 Wilbraham Rd |
$39.56 | 18,809 | 18,173 |
|
Baystate Medical Practices, Inc
759 Chestnut St |
$86.45 | 18,759 | 18,165 |
|
Maura E. Munoz
11 Wilbraham Rd |
$40.85 | 17,724 | 17,017 |
|
Behavioral Health Network, Inc
395 Liberty St |
$44.69 | 17,441 | 16,415 |
|
Ricardo F. Villalba Lopez
50 Wason Avenue |
$1.81 | 17,214 | 15,529 |
|
Moris Pardo
299 Carew St Ste 207 |
$53.95 | 16,059 | 15,654 |
|
Orlando L Torres
140 High St |
$49.20 | 15,985 | 15,557 |
|
Cortney Cristen Haynes
11 Wilbraham Rd |
$44.48 | 15,288 | 14,644 |
|
Afc Physicians Of Massachusetts, Pc
415 Cooley St |
$87.12 | 14,994 | 14,718 |
|
Right Choice Health Group Llc
125 Liberty St |
$83.73 | 14,975 | 4,784 |
|
Maria Ethel Evales
299 Carew St Ste 126 |
$68.67 | 14,427 | 12,504 |
|
Paul Azimov
3640 Main St Ste 102 |
$58.48 | 14,388 | 14,045 |
|
Wendelin K. Reymond
3400 Main Street |
$59.89 | 14,258 | 13,931 |
|
Antonette M Comeau
819 Worcester St |
$54.08 | 14,232 | 10,514 |
|
Carolyn S Goldstein
50 Wason Ave |
$29.24 | 14,029 | 13,589 |
|
The Shriners' Hospital For Children
516 Carew St |
$204.87 | 13,974 | 13,450 |
|
Nicola T. Sumorok
140 High St |
$40.32 | 13,950 | 13,698 |
|
Lauren B Meade
140 High St |
$39.54 | 13,845 | 13,550 |
|
Beata Tyminska-Paluchowska
299 Carew St |
$57.79 | 13,304 | 12,096 |
|
Kathryn A Jobbins
140 High St |
$45.36 | 12,886 | 12,608 |
|
Mark S. Kassis
3400 Main St |
$57.62 | 12,792 | 12,447 |
|
Magdalena Czerkawska-Zydzik
299 Carew St |
$58.95 | 12,464 | 11,238 |
|
James Francis Carroll
271 Carew St |
$67.29 | 12,298 | 9,474 |
|
Mayu Sekiguchi Runge
140 High St |
$36.64 | 11,661 | 11,351 |
|
Mark Stanley Skalski
305 Bicentennial Hwy |
$51.20 | 11,605 | 10,972 |
|
John R. O'Reilly
140 High St |
$47.52 | 11,359 | 11,072 |
|
Linda J Canty
140 High St |
$48.21 | 10,809 | 10,576 |
|
Booker T. Bush
140 High St |
$43.02 | 10,665 | 10,460 |
|
Christine A Sickle
1515 Allen St, Suite B |
$60.55 | 10,426 | 9,485 |
|
Eric C Churchill
140 High Street |
$40.32 | 10,309 | 10,104 |
|
Community Services Institute, Inc.
1695 Main St |
$67.92 | 10,245 | 9,729 |
|
Robin B Buckingham
3400 Main St |
$50.71 | 10,222 | 7,751 |
|
Paul S Salva
781 Chestnut St |
$83.32 | 10,115 | 9,516 |
|
Christopher Wolf
175 Carew Street |
$44.33 | 9,966 | 9,499 |
|
Deborah Marie Branco
759 Chestnut St |
$54.40 | 9,922 | 8,853 |
|
Phanthila Singhaviranon
50 Wason Ave |
$35.95 | 9,871 | 9,694 |
|
Sharon Baribeau
3300 Main Street |
$54.57 | 9,724 | 7,072 |
|
Frances M Hurley
80 Congress St |
$58.95 | 9,685 | 4,587 |
|
Matthew D Sadof
140 High St |
$43.55 | 9,647 | 9,216 |
|
Amy L Pelletier
50 Wason Ave |
$31.13 | 9,589 | 9,227 |
|
Daniel I Plosky
100 Wason Avenue |
$53.18 | 9,528 | 9,316 |
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 Springfield, MA?
Based on public Medicaid payment data, the average Medicaid reimbursement for Office Visit in Springfield, MA is $71.94 per claim, based on 2,654,243 claims from 1017 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 Springfield, MA?
There are 1017 Medicaid providers offering Office Visit related services in Springfield, MA according to public payment data.
What is the price range for Office Visit in Springfield, MA?
Medicaid reimbursement for Office Visit in Springfield, MA ranges from $0.00 to $446.14 per claim, with an average of $71.94. 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 Springfield, MA
Substance Abuse Treatment
Avg $20.44
8,386,620 claims
Blood Work & Lab Tests
Avg $7.91
2,608,014 claims
Psychiatric Evaluation
Avg $77.04
2,573,099 claims
Behavioral & Mental Health Therapy
Avg $146.55
1,190,715 claims
Emergency Room Visit
Avg $119.65
960,403 claims
Non-Emergency Medical Transportation
Avg $22.82
911,143 claims
Personal Care Services
Avg $86.61
764,746 claims
Case Management Services
Avg $59.99
712,832 claims