Average Medicaid Office Visit Payments in Troy, PA: $49.49
Avg. Paid
$49.49
Range
$0.00 – $84.51
Total Claims
35,876
Providers
14
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 Troy, PA
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Kari S. Wood
285 Guthrie Dr |
$61.49 | 17,176 | 15,767 |
|
Stephen James Renzi
160 S Railroad St |
$33.62 | 8,292 | 7,392 |
|
Kristine M Tofts
285 Guthrie Dr |
$57.09 | 6,877 | 6,492 |
|
Richard T. Husband
45 Mud Creek Rd |
$9.88 | 1,640 | 1,494 |
|
North Penn Comprehensive Health Services
45 Mud Creek Rd |
$0.00 | 943 | 788 |
|
Marcelinda K Griffiths
45 Mud Creek Rd |
$1.57 | 251 | 246 |
|
Navin Kumar Subrayappa
285 Guthrie Dr |
$71.80 | 206 | 196 |
|
Angela Lorine Mosser
45 Mud Creek Rd |
$29.66 | 174 | 137 |
|
Cynthia Ann Meyer
45 Mud Creek Rd |
$20.95 | 96 | 87 |
|
Robert J Orr
45 Mud Creek Rd |
$39.11 | 91 | 86 |
|
Guthrie Medical Group, P.C.
285 Guthrie Dr |
$84.51 | 51 | 43 |
|
Melissa Sue Mcconnell
160 S Railroad St |
$35.00 | 37 | 33 |
|
Maureen D. Strobel
45 Mud Creek Rd |
$0.00 | 30 | 27 |
|
Jodi Lynne Duda
547 Canton St |
$18.14 | 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 Troy, PA?
Based on public Medicaid payment data, the average Medicaid reimbursement for Office Visit in Troy, PA is $49.49 per claim, based on 35,876 claims from 14 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 Troy, PA?
There are 14 Medicaid providers offering Office Visit related services in Troy, PA according to public payment data.
What is the price range for Office Visit in Troy, PA?
Medicaid reimbursement for Office Visit in Troy, PA ranges from $0.00 to $84.51 per claim, with an average of $49.49. 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 Troy, PA
Physical Therapy
Avg $50.31
12,002 claims
Dental Cleaning & Exam
Avg $19.86
6,608 claims
Eye Exam
Avg $36.08
5,527 claims
Speech Therapy
Avg $9.60
4,577 claims
EKG / ECG (Electrocardiogram)
Avg $9.80
2,639 claims
Blood Work & Lab Tests
Avg $10.57
2,455 claims
Durable Medical Equipment (DME)
Avg $62.18
2,110 claims
Ambulance Transport
Avg $152.28
1,720 claims