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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
North Manchester, IN $6.62 $1.73 – $7.69 8,244 2
Ooltewah, TN $11.60 $4.23 – $13.20 8,249 4
Alton, NH $4.80 $4.80 – $4.80 8,249 1
East Moriches, NY $3.48 $1.80 – $3.78 8,265 2
Lyndhurst, NJ $10.15 $8.79 – $15.07 8,272 4
Bluefield, VA $7.15 $2.81 – $9.64 8,275 4
Clinton, TN $12.46 $12.43 – $13.81 8,284 2
La Puente, CA $14.94 $0.00 – $34.41 8,284 4
Palatine, IL $9.04 $0.55 – $23.29 8,286 13
Del Mar, CA $17.60 $17.60 – $17.60 8,287 1
Plano, IL $18.73 $16.19 – $27.88 8,288 2
Benson, NC $19.55 $7.43 – $20.16 8,289 2
Lucedale, MS $21.71 $21.64 – $62.64 8,290 3
Webster, TX $7.95 $0.00 – $20.66 8,298 20
Southgate, MI $30.61 $30.61 – $30.61 8,307 1
Maysville, KY $4.08 $0.00 – $13.34 8,311 6
Brownfield, TX $9.04 $8.81 – $10.31 8,341 2
Andover, MA $11.57 $3.12 – $14.73 8,351 5
Bronxville, NY $8.23 $0.82 – $23.88 8,358 5
Wellesley, MA $13.36 $1.46 – $16.14 8,366 5
Desloge, MO $22.13 $22.11 – $29.83 8,377 2
Coushatta, LA $4.63 $4.41 – $5.04 8,379 2
Glen Dale, WV $12.50 $10.08 – $12.55 8,385 2
Stroudsburg, PA $17.13 $0.00 – $21.89 8,388 5
Biddeford, ME $23.11 $7.25 – $32.17 8,393 13
Waupaca, WI $20.42 $1.23 – $71.31 8,395 20
Fort Dodge, IA $5.97 $0.00 – $16.21 8,400 16
New Martinsville, WV $17.62 $8.56 – $23.75 8,400 3
Wauconda, IL $21.27 $19.03 – $52.13 8,405 5
Massena, NY $9.44 $5.66 – $25.39 8,415 6
Grand Terrace, CA $16.52 $16.52 – $16.52 8,421 1
Sanbornville, NH $14.18 $5.29 – $17.26 8,426 3
London, KY $12.82 $0.00 – $50.56 8,449 13
Solon, OH $13.67 $3.93 – $21.43 8,454 10
Bay Springs, MS $11.30 $7.84 – $17.99 8,462 6
Woodbridge, NJ $9.95 $3.02 – $26.44 8,474 7
Corsicana, TX $7.22 $0.00 – $9.87 8,479 8
Janesville, WI $20.95 $6.93 – $59.39 8,496 6
Lawrence, MA $12.38 $0.00 – $15.97 8,496 8
Peabody, MA $10.75 $3.18 – $29.82 8,503 11
Olathe, KS $9.36 $0.00 – $35.85 8,504 15
Huntington, IN $9.94 $0.41 – $17.89 8,504 5
Brownsville, KY $2.53 $1.12 – $4.11 8,504 3
Mill Valley, CA $19.17 $0.00 – $19.21 8,509 2
Sheridan, CO $24.73 $24.73 – $24.73 8,515 1
Marblehead, MA $5.63 $5.19 – $7.09 8,521 2
Beaufort, NC $14.77 $7.50 – $15.87 8,526 3
Holliston, MA $19.21 $0.00 – $19.24 8,539 2
Richmond Hts, OH $14.73 $10.79 – $14.80 8,545 2
Picayune, MS $5.20 $5.20 – $5.20 8,546 1

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.