Average Medicaid Office Visit Payments in Waltham, MA: $51.98
Avg. Paid
$51.98
Range
$0.78 – $129.88
Total Claims
64,014
Providers
103
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 Waltham, MA
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Kristina E Orio
1030 Main St |
$95.17 | 5,469 | 5,286 |
|
Miriam Claire Goodman
169 Elm St |
$30.96 | 4,431 | 4,048 |
|
George Stanley Sigel
20 High St Ste 1 |
$33.35 | 3,806 | 2,929 |
|
Yuliya Ostrerov
355 Waverly Oaks Rd Ste 125 |
$55.22 | 3,558 | 3,416 |
|
John David Hackett
9 Hope Aveneu |
$45.50 | 2,728 | 2,604 |
|
Larissa Engleman
950 Winter St |
$10.45 | 2,099 | 2,002 |
|
Patriot Urgent Care Professionals, Pc
1030 Main Street |
$110.35 | 1,996 | 1,905 |
|
Henry John Merola
32 South St |
$37.79 | 1,915 | 1,735 |
|
Phillip Heinen
950 Winter St |
$97.59 | 1,885 | 1,785 |
|
Sara Elizabeth Rose-Sauld
52 2Nd Ave Ste 1150 |
$21.21 | 1,859 | 1,590 |
|
Jeffrey A Biller
40 Second Ave |
$78.92 | 1,515 | 1,473 |
|
Aubrey J Katz
40 Second Ave |
$53.45 | 1,480 | 1,424 |
|
Veenu Thakur
20 Hope Ave Ste 204 |
$62.10 | 1,446 | 1,164 |
|
Robert R Wolff
9 Hope Ave |
$73.00 | 1,370 | 1,368 |
|
Peter Seihwan Kim
840 Winter St |
$103.99 | 1,364 | 1,349 |
|
Michelle Marie Cournoyer
20 Hope Ave |
$0.78 | 1,312 | 1,156 |
|
Timothy D Grinnell
840 Winter St |
$37.76 | 1,134 | 1,079 |
|
George Dallos
20 Hope Ave |
$59.70 | 1,040 | 886 |
|
David Y Dominguez
465 Waverley Oaks Rd Ste 100 |
$40.51 | 1,003 | 944 |
|
Jonathan Philip Winickoff
40 2Nd Ave |
$31.10 | 972 | 847 |
|
Jacqueline Marie Burgoyne
Bentley University Health Center |
$43.76 | 971 | 946 |
|
Stephanie M Bryson
21 Fuller St Apt 1 |
$103.47 | 951 | 888 |
|
Gigi Girgis
20 Hope Ave |
$32.64 | 929 | 917 |
|
Chuanyun Gao
355 Waverley Oaks Rd |
$50.18 | 914 | 899 |
|
Stephen D Anesi
1440 Main Street |
$30.47 | 839 | 797 |
|
Nancy Gracin
40 2Nd Ave |
$52.34 | 836 | 815 |
|
Michael Andrew Vrolyk
52 Second Ave |
$34.63 | 826 | 793 |
|
Kamau Karanja
564 Main St |
$31.65 | 792 | 752 |
|
Kristen M. Haddon
355 Waverly Oaks Rd Ste 125 |
$49.08 | 715 | 683 |
|
Suzanne Carol Johnston
9 Hope Avenue |
$49.72 | 669 | 665 |
|
Kurt J Hofmann
71 Border Rd Ste 300 |
$42.04 | 664 | 622 |
|
Sarah Pritchett Zimmerman
40 2Nd Ave Ste 400 |
$45.86 | 650 | 621 |
|
April K Kavanagh
52 Second Ave Ste 400 |
$29.53 | 641 | 596 |
|
Caroline Claire O'Donnell
9 Hope Ave |
$29.59 | 637 | 622 |
|
Hadia Fatima Tirmizi
231 Moody Street |
$40.36 | 581 | 565 |
|
Rifat B Dweik
20 Hope Ave |
$21.74 | 570 | 564 |
|
Charles Stephen Foster
1440 Main Street |
$32.66 | 564 | 529 |
|
Rachel Ackerman
355 Waverly Oaks Rd Ste 200 |
$22.04 | 511 | 485 |
|
Margaret Duddy
564 Main St |
$3.01 | 498 | 471 |
|
Elizabeth Kirstein
1030 Main St |
$129.88 | 454 | 444 |
|
Stephen Takeo Nishiyama
40 Second Ave |
$60.87 | 394 | 366 |
|
Jacob M Drew
71 Border Rd Ste 300 |
$15.62 | 378 | 375 |
|
Chithra Susan Kuriakose
Waltham Medical Group |
$42.68 | 370 | 349 |
|
Janet L Antonioni
465 Waverley Oaks Rd |
$63.04 | 339 | 328 |
|
Ronald Richard Caruso
9 Hope Ave |
$36.71 | 328 | 316 |
|
Wissam J Khoory
20 Hope Ave |
$74.79 | 308 | 294 |
|
Louisa Eileen Martin
210 Bear Hill Rd |
$77.43 | 288 | 274 |
|
Sabrina Dar
36 River St |
$87.12 | 266 | 191 |
|
Barry A Ehrlich
9 Hope Avenue |
$37.54 | 264 | 261 |
|
Wendy Gaines
9 Hope Ave |
$46.63 | 262 | 256 |
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 Waltham, MA?
Based on public Medicaid payment data, the average Medicaid reimbursement for Office Visit in Waltham, MA is $51.98 per claim, based on 64,014 claims from 103 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 Waltham, MA?
There are 103 Medicaid providers offering Office Visit related services in Waltham, MA according to public payment data.
What is the price range for Office Visit in Waltham, MA?
Medicaid reimbursement for Office Visit in Waltham, MA ranges from $0.78 to $129.88 per claim, with an average of $51.98. 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 Waltham, MA
Non-Emergency Medical Transportation
Avg $33.95
260,807 claims
Dental Cleaning & Exam
Avg $38.21
163,622 claims
Behavioral & Mental Health Therapy
Avg $108.98
65,023 claims
Blood Work & Lab Tests
Avg $4.02
57,809 claims
Vaccines & Immunizations
Avg $10.90
36,552 claims
Personal Care Services
Avg $73.66
36,404 claims
Speech Therapy
Avg $40.00
23,845 claims
Dental Filling
Avg $78.24
23,740 claims