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 |
|---|---|---|---|---|
| Snead, AL | $16.75 | $0.00 – $43.67 | 6,834 | 6 |
| Thoreau, NM | $143.25 | $132.47 – $163.81 | 6,830 | 2 |
| Cameron, TX | $43.24 | $7.40 – $53.38 | 6,825 | 7 |
| Meeker, OK | $79.91 | $68.98 – $80.10 | 6,821 | 2 |
| Minerva, OH | $50.29 | $28.73 – $60.52 | 6,820 | 5 |
| Arco, ID | $47.46 | $0.00 – $60.25 | 6,817 | 4 |
| Mineral Point, MO | $78.92 | $78.92 – $78.92 | 6,812 | 1 |
| Middlebrook, VA | $54.53 | $46.37 – $54.56 | 6,811 | 2 |
| Garden City, UT | $37.94 | $12.33 – $93.84 | 6,803 | 4 |
| Laporte, IN | $41.02 | $5.45 – $75.53 | 6,802 | 9 |
| Dania Beach, FL | $24.16 | $2.91 – $56.67 | 6,801 | 12 |
| Bentleyville, PA | $29.95 | $0.00 – $63.27 | 6,801 | 7 |
| Mineral Point, WI | $32.27 | $10.36 – $92.24 | 6,800 | 13 |
| Plankinton, SD | $117.83 | $34.34 – $155.91 | 6,800 | 2 |
| Eminence, MO | $88.77 | $16.28 – $95.82 | 6,793 | 5 |
| Sunnyside, UT | $36.66 | $7.93 – $47.29 | 6,775 | 2 |
| Old Orchard Beach, ME | $35.59 | $25.48 – $54.55 | 6,774 | 3 |
| Shell Lake, WI | $35.33 | $19.62 – $59.77 | 6,769 | 9 |
| Kulpmont, PA | $42.89 | $2.72 – $45.62 | 6,764 | 6 |
| Ridgely, TN | $28.86 | $26.44 – $62.43 | 6,752 | 4 |
| North Webster, IN | $64.10 | $62.96 – $80.16 | 6,747 | 2 |
| Cottleville, MO | $62.69 | $39.34 – $91.39 | 6,746 | 7 |
| Folsom, LA | $18.60 | $11.96 – $20.84 | 6,744 | 5 |
| Loretto, KY | $17.24 | $17.24 – $17.24 | 6,739 | 1 |
| Chevak, AK | $120.65 | $0.00 – $424.64 | 6,735 | 10 |
| Perryville, AR | $34.35 | $21.87 – $59.19 | 6,735 | 6 |
| Odessa, WA | $22.89 | $1.36 – $57.25 | 6,733 | 5 |
| Ellaville, GA | $96.84 | $63.90 – $102.91 | 6,733 | 4 |
| Cowden, IL | $0.00 | $0.00 – $0.00 | 6,729 | 2 |
| Calera, OK | $66.17 | $66.17 – $66.17 | 6,729 | 1 |
| Dillsburg, PA | $52.58 | $50.02 – $70.25 | 6,726 | 8 |
| Carle Place, NY | $59.85 | $11.19 – $141.96 | 6,720 | 8 |
| Palmer, TN | $22.54 | $20.78 – $29.99 | 6,719 | 2 |
| Lunenburg, MA | $44.40 | $39.00 – $54.41 | 6,708 | 3 |
| Maplesville, AL | $0.00 | $0.00 – $0.00 | 6,708 | 4 |
| Saint Ansgar, IA | $0.14 | $0.04 – $16.18 | 6,704 | 2 |
| Crystal City, TX | $32.53 | $0.00 – $45.92 | 6,704 | 9 |
| Coldspring, TX | $33.38 | $33.38 – $33.38 | 6,702 | 1 |
| Eminince, MO | $75.78 | $75.78 – $75.78 | 6,702 | 1 |
| New Freedom, PA | $53.49 | $33.75 – $123.50 | 6,702 | 12 |
| Cornish, ME | $17.77 | $2.20 – $35.65 | 6,699 | 4 |
| Ottawa Hills, OH | $71.35 | $45.93 – $72.14 | 6,696 | 2 |
| Millersburg, PA | $34.05 | $0.76 – $53.74 | 6,694 | 4 |
| Wayne, PA | $49.90 | $0.62 – $70.95 | 6,693 | 12 |
| St George, SC | $45.09 | $38.88 – $91.23 | 6,690 | 3 |
| Greenville, RI | $63.38 | $46.04 – $78.02 | 6,689 | 9 |
| Dayton, VA | $63.17 | $25.14 – $98.16 | 6,684 | 7 |
| Torreon, NM | $135.13 | $135.13 – $135.13 | 6,682 | 1 |
| New Carlisle, IN | $54.21 | $43.57 – $60.72 | 6,678 | 4 |
| Harvey, ND | $67.68 | $55.68 – $95.78 | 6,677 | 7 |
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.