Average Medicaid Nursing Facility Care Payments
Typical Medicaid Nursing Facility Care reimbursement across 7,188 cities
Avg. Medicaid Paid
$16.08
Price Range
$0.00 – $380.00
Total Claims
97.6M
Cities
7188
Typical Payment Range
Typical Medicaid Nursing Facility Care payments fall between $5.92 and $20.86 per claim (median: $11.60). The top 10% of payments exceed $35.86.
Based on per-provider averages across all Medicaid claims in this category.
About This Procedure
Skilled nursing facility services for patients who need 24-hour nursing care and rehabilitation services.
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 |
|---|---|---|---|---|
| Chicago, IL | $21.36 | $0.00 – $90.93 | 1,738,984 | 558 |
| Bronx, NY | $12.93 | $0.00 – $92.58 | 1,370,824 | 374 |
| Las Vegas, NV | $32.97 | $0.00 – $124.30 | 1,247,209 | 318 |
| Brooklyn, NY | $13.63 | $0.00 – $146.68 | 1,130,919 | 415 |
| Phoenix, AZ | $42.43 | $0.00 – $107.08 | 1,002,914 | 272 |
| Tampa, FL | $5.95 | $0.00 – $84.28 | 973,086 | 275 |
| Jacksonville, FL | $6.44 | $0.00 – $61.66 | 918,615 | 266 |
| Indianapolis, IN | $12.89 | $0.00 – $73.93 | 832,589 | 253 |
| Miramar, FL | $11.91 | $0.00 – $74.59 | 830,785 | 146 |
| Orlando, FL | $5.85 | $0.00 – $89.43 | 764,097 | 237 |
| Miami, FL | $5.69 | $0.00 – $89.83 | 708,431 | 263 |
| Los Angeles, CA | $24.52 | $0.00 – $725.57 | 652,704 | 305 |
| Baltimore, MD | $30.68 | $-0.72 – $126.75 | 640,028 | 207 |
| Fort Wayne, IN | $10.07 | $0.00 – $66.22 | 584,581 | 188 |
| Asheville, NC | $12.55 | $0.00 – $42.00 | 568,782 | 112 |
| Louisville, KY | $9.76 | $0.00 – $64.12 | 551,162 | 244 |
| Houston, TX | $8.84 | $0.00 – $114.98 | 532,202 | 293 |
| New York, NY | $11.05 | $0.00 – $69.66 | 498,754 | 240 |
| Columbus, OH | $15.93 | $0.00 – $39.95 | 448,954 | 206 |
| Baton Rouge, LA | $7.48 | $0.00 – $23.08 | 443,825 | 98 |
| San Antonio, TX | $8.81 | $0.00 – $80.18 | 438,546 | 192 |
| Dallas, TX | $8.10 | $0.00 – $72.47 | 418,194 | 205 |
| Cincinnati, OH | $15.95 | $0.00 – $41.14 | 414,195 | 190 |
| Cleveland, OH | $13.73 | $0.00 – $65.74 | 389,018 | 215 |
| Saint Louis, MO | $19.98 | $0.00 – $62.72 | 381,628 | 188 |
| San Diego, CA | $49.85 | $0.00 – $345.00 | 328,181 | 138 |
| Knoxville, TN | $13.13 | $0.00 – $32.67 | 319,777 | 114 |
| Silver Spring, MD | $18.02 | $0.00 – $126.51 | 318,176 | 69 |
| Philadelphia, PA | $22.42 | $0.00 – $97.75 | 314,491 | 227 |
| Tucson, AZ | $39.91 | $0.00 – $96.10 | 313,976 | 151 |
| Raleigh, NC | $15.10 | $0.00 – $40.05 | 312,718 | 109 |
| Roanoke, VA | $12.22 | $0.00 – $66.50 | 310,285 | 114 |
| West Haven, CT | $17.08 | $1.26 – $42.17 | 309,972 | 70 |
| Charlotte, NC | $17.89 | $0.00 – $50.18 | 308,276 | 147 |
| Crown Point, IN | $14.43 | $0.00 – $50.81 | 300,981 | 64 |
| Memphis, TN | $9.85 | $0.00 – $80.49 | 300,977 | 89 |
| Columbia, MO | $24.02 | $5.40 – $34.89 | 296,470 | 70 |
| Novi, MI | $32.08 | $0.00 – $60.99 | 296,342 | 18 |
| Nashville, TN | $14.27 | $0.00 – $380.00 | 290,550 | 155 |
| Concord, NC | $17.76 | $0.00 – $38.30 | 283,703 | 109 |
| Scottsdale, AZ | $43.09 | $0.00 – $378.84 | 273,936 | 83 |
| St Petersburg, FL | $10.42 | $0.00 – $60.12 | 272,919 | 90 |
| Staten Island, NY | $10.88 | $0.00 – $69.24 | 271,406 | 96 |
| Oklahoma City, OK | $19.63 | $5.25 – $46.39 | 267,871 | 110 |
| Richmond, VA | $16.25 | $0.00 – $83.82 | 267,829 | 139 |
| Austin, TX | $8.15 | $0.00 – $43.56 | 264,498 | 198 |
| Ocala, FL | $4.57 | $0.00 – $52.03 | 249,508 | 69 |
| Lafayette, LA | $6.08 | $0.00 – $23.22 | 249,068 | 60 |
| Canton, OH | $11.21 | $0.54 – $26.76 | 248,952 | 69 |
| Sherman Oaks, CA | $21.07 | $0.00 – $32.92 | 244,396 | 36 |
Cost Components
National averages for each billing code in this procedure category. Sorted by claim volume.
| Code | Description | Avg. Paid | Claims | Providers |
|---|---|---|---|---|
| 99309 | Nursing facility subseq mod-hi | $17.88 | 43,693,341 | 34,328 |
| 99308 | Nursing facility subseq mod | $12.62 | 42,495,079 | 33,407 |
| 99307 | Nursing facility subsequent low | $8.86 | 6,770,015 | 11,425 |
| 99310 | Nursing facility subseq high | $31.06 | 4,780,807 | 10,125 |
| 99306 | Nursing facility initial high | $40.91 | 1,364,289 | 6,538 |
| 99305 | Nursing facility initial mod | $25.42 | 1,050,487 | 5,595 |
| 99304 | Nursing facility initial compl | $28.74 | 440,459 | 2,566 |
| 99318 | Nursing facility annual assess | $43.42 | 99,072 | 1,360 |
| 99316 | Nursing facility discharge >30 | $36.42 | 66,463 | 505 |
| 99315 | Nursing facility discharge 30m | $32.35 | 39,754 | 273 |
These averages group common billing codes used when providers bill Medicaid for this procedure. Individual costs will vary.