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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
St Johns, FL $8.40 $0.00 – $9.41 8,546 4
Morgan City, LA $5.89 $0.00 – $11.41 8,554 6
Roxbury, MA $13.15 $2.57 – $21.70 8,556 5
Wilmington, OH $11.71 $4.60 – $21.09 8,564 8
Garfield Hts, OH $17.64 $15.34 – $17.67 8,573 2
Carlisle, PA $10.92 $4.98 – $34.03 8,579 6
South Fulton, TN $5.91 $5.62 – $32.38 8,584 2
Vienna, VA $25.21 $14.03 – $58.35 8,596 3
Meadville, MS $14.67 $14.67 – $14.67 8,601 1
Oconomowoc, WI $13.09 $8.54 – $21.18 8,602 3
Sewickley, PA $22.09 $6.32 – $26.08 8,611 5
Fond Du Lac, WI $18.27 $0.95 – $68.91 8,615 9
Snead, AL $0.38 $0.00 – $1.58 8,633 4
Deridder, LA $2.37 $2.00 – $7.61 8,642 3
Gaffney, SC $21.64 $13.18 – $43.44 8,654 3
Waldorf, MD $18.31 $3.31 – $70.46 8,657 6
Thousand Oaks, CA $44.94 $0.00 – $68.89 8,661 14
Ogden, UT $19.27 $1.62 – $27.62 8,666 12
Williamsburg, OH $11.51 $11.51 – $11.51 8,695 1
Thief River Falls, MN $17.17 $17.17 – $17.17 8,698 1
Granada Hills, CA $15.85 $1.32 – $17.55 8,709 5
Stonewall, LA $8.00 $3.73 – $13.27 8,714 3
Dickinson, TX $14.15 $0.86 – $21.38 8,717 7
Unionville, CT $5.70 $5.70 – $5.70 8,721 1
Elkins, WV $26.95 $6.65 – $81.63 8,725 7
Bremerton, WA $15.87 $10.48 – $38.56 8,732 5
Livingston, TN $6.25 $3.37 – $16.73 8,742 4
Oakhurst, NJ $7.08 $0.35 – $30.38 8,752 10
Richton Park, IL $15.50 $4.36 – $28.04 8,762 5
Victoria, TX $9.24 $0.00 – $25.68 8,774 14
Winchester, IN $15.65 $7.27 – $16.39 8,791 3
Bolivar, MO $41.27 $19.80 – $65.42 8,797 8
Randolph, MA $10.69 $5.50 – $16.69 8,799 8
East Stroudsburg, PA $3.64 $0.00 – $17.33 8,803 7
Prestonsburg, KY $8.61 $0.00 – $34.42 8,805 6
Lenoir City, TN $7.25 $4.11 – $11.44 8,805 5
Spotswood, NJ $18.11 $9.44 – $23.68 8,808 3
Oxford, FL $3.90 $2.31 – $4.51 8,816 2
Lexington, NC $30.27 $8.28 – $70.50 8,822 6
Mount Vernon, IL $9.31 $3.31 – $18.03 8,830 7
Roseville, MI $33.70 $14.83 – $50.79 8,832 6
Island Lake, IL $9.38 $9.38 – $9.38 8,833 1
Hurst, TX $4.22 $0.00 – $9.85 8,846 3
Weston, WV $14.40 $5.33 – $15.32 8,849 4
Yankton, SD $26.13 $13.57 – $29.83 8,853 3
Clarksville, TX $3.83 $2.14 – $5.27 8,885 3
Goshen, IN $9.84 $2.87 – $33.64 8,888 7
Deatsville, AL $4.90 $4.24 – $5.41 8,889 2
Newark, CA $42.41 $1.97 – $42.65 8,890 2
Farmingville, NY $8.67 $6.70 – $9.69 8,891 3

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.