Based on public Medicaid payment data.

Average Medicaid Office Visit Payments in Worcester, MA: $63.47

Avg. Paid

$63.47

Range

$0.00 – $226.96

Total Claims

2,032,687

Providers

1,521

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 Worcester, MA

Provider	Avg. Paid	Claims	Patients
Umass Memorial Medical Center, Inc. 55 Lake Avenue	$128.35	233,716	206,567
Mohamad Amjad Bahnassi Behavioral Healthcare Services	$69.99	43,201	40,276
Community Healthlink Inc 12 Queen Street	$60.84	37,695	35,619
Kimberly Beth Abdow 435 Shrewsbury St	$64.30	29,569	27,300
Quang P Le 456 Park Ave	$58.14	22,370	20,149
Anthony C Tabacco 425 Lake Ave N	$53.96	19,056	16,121
Kevin Phillipp Nardone 435 Shrewsbury St	$75.65	17,067	16,081
Jon Trister 10 Winthrop St	$28.00	16,409	14,900
Umass Memorial Medical Group Inc 55 Lake Ave N	$71.65	16,308	15,004
Ian A Harding 45 Oak Ave	$46.45	13,777	12,693
Orobosa Osawonuyi 435 Shrewsbury St	$91.28	13,505	11,954
Spectrum Health Systems, Inc 585 Lincoln St	$77.63	13,225	11,898
Tam Chang 456 Park Avenue	$45.42	12,902	12,117
Behavioral Healthcare Services 435 Shrewsbury St	$86.55	12,658	11,674
Himabindu Muddana 10 Winthrop St	$64.51	12,173	11,262
Nicholas Peter Pacella 45 Oak Ave	$51.34	11,338	10,422
Malabika Dey 291 Lincoln St	$50.36	11,231	10,735
Daniel H Terbush 411 Chandler St	$59.37	11,212	7,503
Urgent Care Centers Of Central Massachusetts, Llc 500 Lincoln St	$87.38	11,007	10,736
Youth Opportunities Upheld, Inc. 135 Gold Star Blvd	$98.38	10,450	9,617
Lynn Galvin 585 Lincoln St	$70.22	10,411	9,681
Luis A Garcia 291 Lincoln St	$65.10	9,833	9,164
Melissa Ng 121 Lincoln St	$61.84	9,539	6,371
Demian G Mousad 116 Belmont St Rm 34	$43.28	9,309	8,332
Rosa Isabel Rincon - Rivero 45 Oak Ave	$63.72	9,298	8,707
Counseling & Assessment Clinic Of Worcester Llc 255 Park Ave Ste 804	$65.40	8,974	8,499
Kirti Nagpal 10 Winthrop St	$50.27	8,911	8,164
Jessica Crawford-Grey 425 Lake Ave N	$43.40	8,625	8,102
Paulette R Kimball-Wren 10 Winthrop St	$70.51	8,511	7,970
Seth G. Kates 100 Martin Luther King Jr. Blvd.	$42.79	8,407	8,295
Julia M. Feudo 45 Oak Ave	$51.65	8,401	7,932
William W. Tollefsen 119 Belmont St	$88.15	8,293	8,098
Stephen Zombil 116 Belmont St Rm 43	$52.85	8,076	7,612
Ronald B Cruz 291 Lincoln St	$45.91	7,624	7,345
Reliant Medical Group, Inc 5 Neponset St	$47.83	7,472	6,696
Ashley E. Schaefer 950 Main St	$25.82	7,439	6,459
Urgent Care Centers Of Central Massachusetts, Llc 348 Greenwood St	$86.06	7,391	7,091
Sahdev R Passey 10 Winthrop St	$51.04	7,367	6,904
Steven M Davis 85 Prescott St	$48.05	7,134	6,941
Rita J Semaan 1 W Boylston St	$55.25	6,883	6,688
Syed H Kamil 55 Lake Ave N	$43.60	6,863	6,810
Mohamad R. Och 425 Lake Ave N Ste 101	$45.28	6,793	6,183
Nosheen Ali Ishaque 291 Lincoln St	$58.63	6,721	6,574
Thomas Lee Rosenfeld 5 Neponset St	$86.46	6,698	6,604
John Job 130 Lincoln St Ste 6	$54.87	6,652	6,379
Nada M Mowlood 55 Lake Ave N	$5.26	6,358	5,654
Angela Beeler 55 Lake Ave N	$24.83	6,311	6,165
Adrian Kohn 10 Lincoln Sq	$90.14	6,204	5,938
Sheila E O'Shea 119 Belmont St	$18.10	6,076	5,875
Errol S Mortimer 55 Lake Ave N	$41.17	6,029	5,790

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 Worcester, MA?

Based on public Medicaid payment data, the average Medicaid reimbursement for Office Visit in Worcester, MA is $63.47 per claim, based on 2,032,687 claims from 1521 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 Worcester, MA?

There are 1521 Medicaid providers offering Office Visit related services in Worcester, MA according to public payment data.

What is the price range for Office Visit in Worcester, MA?

Medicaid reimbursement for Office Visit in Worcester, MA ranges from $0.00 to $226.96 per claim, with an average of $63.47. Private insurance and self-pay costs are typically higher than these Medicaid rates.

Average Medicaid Office Visit Payments in Worcester, MA: $63.47

Providers Offering Office Visit in Worcester, MA

What to Expect: Office Visit

Cost Components

Frequently Asked Questions

Office Visit in Other Cities

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Other Procedures in Worcester, MA

Substance Abuse Treatment

Psychiatric Evaluation

Non-Emergency Medical Transportation

Home Health Visit

Dental Cleaning & Exam

Blood Work & Lab Tests

Behavioral & Mental Health Therapy

Emergency Room Visit