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 |
|---|---|---|---|---|
| Black Rock, AR | $24.01 | $24.01 – $24.01 | 17 | 1 |
| Hemingford, NE | $76.55 | $76.55 – $76.55 | 17 | 1 |
| Laporte, PA | $27.18 | $27.18 – $27.18 | 17 | 1 |
| Munday, TX | $8.25 | $8.25 – $8.25 | 17 | 1 |
| Mcville, ND | $101.06 | $101.06 – $101.06 | 17 | 1 |
| Somis, CA | $62.68 | $62.68 – $62.68 | 17 | 1 |
| Leeton, MO | $22.63 | $22.63 – $22.63 | 17 | 1 |
| Trappe, PA | $34.18 | $34.18 – $34.18 | 17 | 1 |
| E Corinth, VT | $0.00 | $0.00 – $0.00 | 18 | 1 |
| Mc Calla, AL | $31.03 | $31.03 – $31.03 | 18 | 1 |
| Jbsa-Randolph Afb, TX | $21.96 | $21.96 – $21.96 | 18 | 1 |
| Honey Grove, TX | $28.79 | $28.79 – $28.79 | 18 | 1 |
| Gatesville, NC | $38.12 | $38.12 – $38.12 | 18 | 1 |
| Port Alsworth, AK | $543.16 | $543.16 – $543.16 | 18 | 1 |
| Ijamsville, MD | $0.00 | $0.00 – $0.00 | 18 | 1 |
| Speculator, NY | $6.95 | $6.95 – $6.95 | 18 | 1 |
| Macneal, IL | $16.15 | $16.15 – $16.15 | 18 | 1 |
| Council, NC | $0.00 | $0.00 – $0.00 | 18 | 1 |
| Snow Shoe, PA | $39.36 | $39.36 – $39.36 | 18 | 1 |
| Farmersville, OH | $36.43 | $36.43 – $36.43 | 18 | 1 |
| Barnum, MN | $0.00 | $0.00 – $0.00 | 19 | 1 |
| Kokhanok, AK | $0.00 | $0.00 – $0.00 | 19 | 1 |
| Hillsboro, WV | $8.01 | $8.01 – $8.01 | 19 | 1 |
| West Milwaukee, WI | $0.00 | $0.00 – $0.00 | 19 | 1 |
| Walnut Park, CA | $0.00 | $0.00 – $0.00 | 19 | 1 |
| Lovleand, CO | $63.87 | $63.87 – $63.87 | 19 | 1 |
| San Bernardono, CA | $71.48 | $71.48 – $71.48 | 19 | 1 |
| Crawford, CO | $74.21 | $74.21 – $74.21 | 19 | 1 |
| Glen Echo, MD | $108.50 | $108.50 – $108.50 | 19 | 1 |
| Cotton Plant, AR | $0.00 | $0.00 – $0.00 | 19 | 1 |
| Dodd City, TX | $24.00 | $24.00 – $24.00 | 19 | 1 |
| Ft Meade, MD | $56.93 | $56.93 – $56.93 | 19 | 1 |
| Mart, TX | $12.30 | $12.30 – $12.30 | 20 | 1 |
| Creedmore, NC | $70.05 | $70.05 – $70.05 | 20 | 1 |
| San Jon, NM | $65.66 | $65.66 – $65.66 | 20 | 1 |
| New Harbor, ME | $20.33 | $20.33 – $20.33 | 20 | 1 |
| Cunningham, KS | $294.78 | $294.78 – $294.78 | 20 | 1 |
| Garden City, MO | $15.95 | $15.95 – $15.95 | 20 | 1 |
| Double Oak, TX | $23.93 | $23.93 – $23.93 | 20 | 1 |
| Willamsburgh, VA | $76.92 | $76.92 – $76.92 | 20 | 1 |
| Poblado Rosario, PR | $0.00 | $0.00 – $0.00 | 20 | 1 |
| Clarkson, NE | $158.35 | $158.35 – $158.35 | 20 | 1 |
| Howells, NE | $144.06 | $144.06 – $144.06 | 20 | 1 |
| Glen Burne, MD | $66.66 | $66.66 – $66.66 | 20 | 1 |
| North Tustin, CA | $318.75 | $318.75 – $318.75 | 21 | 1 |
| Garrett, KY | $46.33 | $46.33 – $46.33 | 21 | 1 |
| West Yellowstone, MT | $68.23 | $68.23 – $68.23 | 21 | 1 |
| New Rockford, ND | $654.00 | $654.00 – $654.00 | 21 | 1 |
| Brooklandville, MD | $67.69 | $67.69 – $67.69 | 21 | 1 |
| New, NY | $106.66 | $106.66 – $106.66 | 21 | 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.