Average Medicaid Office Visit Payments in Wilmington, MA: $42.22
Avg. Paid
$42.22
Range
$2.32 – $132.80
Total Claims
13,941
Providers
24
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 Wilmington, MA
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
John L Maddox
500 Salem St |
$49.25 | 4,827 | 4,378 |
|
Alison Curcio
500 Salem Street |
$2.32 | 2,520 | 2,456 |
|
Theodore Guldemond
500 Salem St |
$76.13 | 1,508 | 1,446 |
|
Sharon Ann Stotsky
64 Concord Street |
$22.92 | 1,356 | 1,204 |
|
Wilmington Family Counseling Service Inc
5 Middlesex Ave |
$56.35 | 386 | 318 |
|
Katie-Ann Xydias
222 Main St |
$35.74 | 357 | 324 |
|
Pamela D Corrigan
5 Middlesex Ave |
$80.19 | 342 | 324 |
|
Joseph Costagliola
66 Concord Street |
$43.42 | 289 | 277 |
|
Daniel M Carson
500 Salem St |
$64.15 | 273 | 261 |
|
Maren Hennigan Puder
500 Salem St |
$32.79 | 271 | 267 |
|
Hoai Nu T Vo
64C Concord St |
$29.84 | 251 | 239 |
|
Rebecca Ann Hutchinson
66B Concord St |
$53.78 | 239 | 211 |
|
Normand A Tanguay
500 Salem St |
$64.72 | 207 | 200 |
|
Anthony Justin Tomich
222 Main St |
$17.57 | 174 | 161 |
|
Jenna R Comeau
234 Main St |
$66.24 | 170 | 170 |
|
Sandy Stephens
500 Salem St |
$64.91 | 144 | 138 |
|
Kshitij Gupta
500 Salem St Ste 2 |
$24.35 | 117 | 110 |
|
Anna Jessica Musialowski
66B Concord St |
$132.80 | 113 | 113 |
|
Carolyn J Sedor
500 Salem St |
$70.13 | 106 | 99 |
|
Cathy D'Augusta
66 Concord St |
$38.62 | 94 | 91 |
|
Edward Curcio
500 Salem Street |
$69.49 | 90 | 90 |
|
Mark A Macklis
500 Salem St |
$47.91 | 54 | 52 |
|
Gayathry Sooriyakumar Nene
500 Salem St |
$50.98 | 41 | 41 |
|
Terese Frazier Landry
203 Lowell St |
$83.16 | 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 Wilmington, MA?
Based on public Medicaid payment data, the average Medicaid reimbursement for Office Visit in Wilmington, MA is $42.22 per claim, based on 13,941 claims from 24 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 Wilmington, MA?
There are 24 Medicaid providers offering Office Visit related services in Wilmington, MA according to public payment data.
What is the price range for Office Visit in Wilmington, MA?
Medicaid reimbursement for Office Visit in Wilmington, MA ranges from $2.32 to $132.80 per claim, with an average of $42.22. 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 Wilmington, MA
Ambulance Transport
Avg $88.49
155,488 claims
Home Health Visit
Avg $43.47
109,260 claims
Non-Emergency Medical Transportation
Avg $16.89
61,732 claims
Durable Medical Equipment (DME)
Avg $25.39
27,017 claims
Personal Care Services
Avg $54.42
21,259 claims
Behavioral & Mental Health Therapy
Avg $72.68
13,767 claims
Psychiatric Evaluation
Avg $90.31
7,137 claims
Vaccines & Immunizations
Avg $8.48
5,177 claims