Average Medicaid Office Visit Payments
Typical Medicaid Office Visit reimbursement across 14,934 cities
Avg. Medicaid Paid
$51.55
Price Range
$0.00 – $907.39
Total Claims
1469.2M
Cities
14934
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.
About This Procedure
A standard doctor's office visit for evaluation and management of medical conditions. Includes new patient visits, follow-up visits, and consultations.
Why do these costs look low?
These figures represent Medicaid reimbursement rates — the amounts that state Medicaid programs actually paid providers. Medicaid typically reimburses significantly less than private insurance or out-of-pocket prices. If you have private insurance or are paying cash, expect higher costs. See the cost components below for per-code averages.
Costs by City
| City | Avg. Paid | Min / Max | Claims | Providers |
|---|---|---|---|---|
| Parkton, MD | $93.57 | $42.59 – $108.50 | 53 | 2 |
| Millington, MI | $35.52 | $35.52 – $35.52 | 53 | 1 |
| Carnesville, GA | $27.54 | $27.54 – $27.54 | 53 | 1 |
| Slater, IA | $38.08 | $38.08 – $38.08 | 53 | 1 |
| Bermuda Dunes, CA | $0.00 | $0.00 – $0.00 | 53 | 1 |
| Pensacola Beach, FL | $768.89 | $768.89 – $768.89 | 53 | 1 |
| Pt Charlotte, FL | $39.21 | $39.21 – $39.21 | 53 | 1 |
| Mount Gretna, PA | $0.00 | $0.00 – $0.00 | 53 | 1 |
| Greenland, NH | $46.22 | $46.22 – $46.22 | 53 | 1 |
| Durham, ME | $15.56 | $15.56 – $15.56 | 53 | 1 |
| South Hackensack, NJ | $30.06 | $30.06 – $30.06 | 53 | 1 |
| N Barrington, IL | $7.94 | $7.94 – $7.94 | 54 | 1 |
| Oklahoma City, OH | $141.91 | $141.91 – $141.91 | 54 | 1 |
| Bay Harbour Islands, FL | $1.42 | $1.42 – $1.42 | 54 | 1 |
| Colubmbia, MO | $71.90 | $71.90 – $71.90 | 54 | 1 |
| Gilman, WI | $20.61 | $20.61 – $20.61 | 54 | 1 |
| Grand Island, FL | $5.64 | $5.64 – $5.64 | 54 | 1 |
| Seven Points, TX | $35.78 | $35.78 – $35.78 | 54 | 1 |
| Youngstown, NY | $55.65 | $55.65 – $55.65 | 54 | 1 |
| Churchville, PA | $4.36 | $4.36 – $4.36 | 55 | 1 |
| Huntsville, UT | $0.00 | $0.00 – $0.00 | 55 | 1 |
| Blk Mtn, NC | $26.10 | $26.10 – $26.10 | 55 | 1 |
| El Sobrante, CA | $63.57 | $63.57 – $63.57 | 55 | 1 |
| Forman, ND | $42.09 | $42.09 – $42.09 | 55 | 1 |
| De Soto, KS | $29.29 | $26.03 – $39.84 | 55 | 2 |
| Milltown, WI | $18.48 | $18.48 – $18.48 | 55 | 1 |
| Lynnville, TN | $29.40 | $29.40 – $29.40 | 55 | 1 |
| Nashport, OH | $299.35 | $299.35 – $299.35 | 55 | 1 |
| Mescalero, NM | $270.35 | $246.08 – $341.43 | 55 | 2 |
| Brezzy Point, MN | $77.37 | $77.37 – $77.37 | 55 | 1 |
| Stewardson, IL | $55.56 | $55.56 – $55.56 | 56 | 1 |
| Madison, GA | $13.87 | $13.87 – $13.87 | 56 | 1 |
| Monterey, IN | $27.73 | $27.73 – $27.73 | 56 | 1 |
| Blue Ridge, VA | $80.37 | $80.37 – $80.37 | 56 | 1 |
| Petrolia, PA | $0.00 | $0.00 – $0.00 | 56 | 1 |
| Sea Bright, NJ | $31.03 | $31.03 – $31.03 | 56 | 1 |
| Wellington, TX | $67.43 | $21.36 – $219.80 | 56 | 2 |
| Bainbridge Is, WA | $53.40 | $53.40 – $53.40 | 56 | 1 |
| Blufield, VA | $4.07 | $4.07 – $4.07 | 56 | 1 |
| Mc Cordsville, IN | $0.00 | $0.00 – $0.00 | 56 | 1 |
| Hitchcock, TX | $32.07 | $32.07 – $32.07 | 57 | 1 |
| Biscayne Park, FL | $6.64 | $6.64 – $6.64 | 57 | 1 |
| Holden, ME | $7.68 | $7.68 – $7.68 | 57 | 1 |
| Blair, WI | $17.42 | $17.42 – $17.42 | 57 | 1 |
| Shingle Springs, CA | $384.23 | $384.23 – $384.23 | 58 | 1 |
| Flagler Beach, FL | $42.06 | $42.06 – $42.06 | 58 | 1 |
| Lovettsville, VA | $53.99 | $53.99 – $53.99 | 58 | 1 |
| Trenton, SC | $79.94 | $79.94 – $79.94 | 58 | 1 |
| Onalaska, WA | $0.00 | $0.00 – $0.00 | 58 | 1 |
| Onsted, MI | $0.00 | $0.00 – $0.00 | 59 | 1 |
Cost Components
National averages for each billing code in this procedure category. Sorted by claim volume.
| 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 averages group common billing codes used when providers bill Medicaid for this procedure. Individual costs will vary.