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Based on public Medicaid payment data.

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 β€” 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
Raymore, MO $10.05 $5.89 – $10.17 6,447 2
Covington, KY $6.64 $0.00 – $26.99 6,453 6
Iowa City, IA $11.91 $5.27 – $40.36 6,455 14
Moundville, AL $3.85 $3.85 – $3.85 6,460 1
East Saint Louis, IL $13.89 $10.77 – $19.78 6,483 3
Benton, KY $4.52 $0.84 – $9.77 6,494 9
Northfield, IL $19.18 $12.42 – $26.69 6,495 3
Burley, ID $19.63 $0.00 – $51.71 6,505 6
Montgomery, NY $7.13 $5.42 – $8.42 6,506 4
Godfrey, IL $3.13 $1.57 – $6.51 6,510 2
Mountain City, TN $9.72 $7.98 – $29.80 6,532 5
Salem, AR $15.57 $11.95 – $22.09 6,533 9
Powell, OH $21.54 $4.07 – $28.35 6,533 6
Ponchatoula, LA $8.11 $4.54 – $10.33 6,535 3
Ypsilanti, MI $29.00 $0.30 – $58.20 6,557 9
Jackson, KY $30.55 $10.00 – $37.89 6,559 5
Manhasset, NY $3.47 $1.90 – $13.16 6,560 6
Peebles, OH $8.14 $8.14 – $8.14 6,562 1
Oakdale, NY $3.03 $3.03 – $3.03 6,566 1
Farmington, NM $25.30 $0.00 – $31.82 6,580 8
Woodbury, NY $9.33 $0.00 – $13.69 6,594 4
Shaker Heights, OH $14.21 $0.00 – $16.93 6,597 6
Bend, OR $15.47 $0.00 – $44.03 6,600 12
Middle Island, NY $3.18 $3.18 – $3.18 6,603 1
Clinton, NC $18.35 $10.36 – $31.27 6,606 6
Land O Lakes, FL $13.81 $0.00 – $22.62 6,609 7
Pueblo, CO $36.21 $2.90 – $149.23 6,609 14
Clinton, MS $15.30 $6.30 – $17.85 6,613 4
Bethel, OH $16.03 $8.01 – $16.21 6,615 2
Grass Valley, CA $9.04 $0.00 – $10.90 6,624 6
Leeds, AL $0.87 $0.87 – $0.87 6,630 1
Rancho Cordova, CA $4.80 $0.00 – $19.39 6,636 9
Wheeling, WV $15.43 $5.19 – $19.71 6,642 7
Whiting, NJ $16.77 $5.36 – $19.25 6,645 2
Long Island City, NY $8.01 $5.36 – $33.42 6,649 6
Irvington, KY $5.70 $0.96 – $5.88 6,653 3
Fayetteville, WV $10.13 $5.71 – $11.42 6,660 3
Clovis, CA $5.08 $1.70 – $29.86 6,663 4
Bryan, TX $5.04 $2.45 – $9.51 6,663 3
Newburgh, IN $4.94 $0.00 – $11.41 6,676 9
Kimbolton, OH $11.20 $11.20 – $11.20 6,676 1
West Jordan, UT $13.46 $3.62 – $75.95 6,678 3
Alexandria, KY $12.29 $12.29 – $12.29 6,682 1
Orleans, IN $9.26 $9.12 – $9.38 6,682 3
Muscatine, IA $21.36 $0.00 – $39.23 6,685 7
Conneaut, OH $11.00 $6.10 – $13.93 6,707 5
Mays Landing, NJ $20.50 $10.02 – $30.38 6,708 3
Heber City, UT $18.45 $1.68 – $37.54 6,716 5
Southbridge, MA $20.41 $5.09 – $21.15 6,721 4
South Plainfield, NJ $9.69 $0.00 – $14.48 6,731 8

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.