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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
Clear Lake, SD $33.38 $33.38 – $33.38 48 1
Highlands, NJ $2.33 $2.33 – $2.33 48 1
North Potomac, MD $31.50 $31.50 – $31.50 49 1
Magnolia, TX $6.72 $4.38 – $11.54 49 2
Marion, IA $5.29 $5.29 – $5.29 49 1
Gowrie, IA $2.67 $2.67 – $2.67 49 1
La Plata, MO $12.52 $12.52 – $12.52 49 1
Painted Post, NY $19.23 $19.23 – $19.23 49 1
Kerens, TX $5.19 $5.19 – $5.19 49 1
Mulberry, AR $5.56 $5.56 – $5.56 49 1
Jefferson, SC $34.09 $34.09 – $34.09 49 1
Jarrell, TX $11.55 $11.55 – $11.55 49 1
Franklin, TX $0.00 $0.00 – $0.00 49 1
Gustine, CA $2.48 $2.48 – $2.48 50 1
Cheney, WA $10.75 $10.75 – $10.75 50 1
North Smithfield, RI $11.63 $11.63 – $11.63 50 1
Berlin, OH $2.22 $2.22 – $2.22 50 1
Hidalgo, TX $0.00 $0.00 – $0.00 50 1
Pounding Mill, VA $9.00 $9.00 – $9.00 50 1
Taft, CA $0.00 $0.00 – $0.00 51 1
Ochelata, OK $38.71 $38.71 – $38.71 51 1
Pineville, LA $0.64 $0.64 – $0.64 52 1
Harrisville, UT $26.89 $26.89 – $26.89 52 1
Foreman, AR $10.54 $10.54 – $10.54 52 1
Highland, KS $32.04 $32.04 – $32.04 52 1
Pendleton, OR $22.47 $13.98 – $37.66 53 2
Kill Devil Hills, NC $0.00 $0.00 – $0.00 53 1
Goshen, NY $3.58 $3.58 – $3.58 53 1
Saint Marys, WV $0.59 $0.59 – $0.59 53 1
Wadena, MN $188.69 $188.69 – $188.69 53 1
East Setauket, NY $5.42 $0.00 – $7.56 53 2
Pennsburg, PA $52.12 $52.12 – $52.12 53 1
Brewster, WA $13.74 $13.74 – $13.74 53 1
Sterling, MA $1.05 $1.05 – $1.05 53 1
Middlesex, NJ $6.45 $6.45 – $6.45 53 1
Gardner, KS $0.00 $0.00 – $0.00 53 1
Granite Falls, MN $74.44 $74.44 – $74.44 53 1
Tribune, KS $55.59 $55.59 – $55.59 53 1
Mahnomen, MN $75.08 $75.08 – $75.08 53 1
Elkland, PA $3.85 $3.85 – $3.85 53 1
Alto, TX $20.00 $20.00 – $20.00 53 1
Tazewell, TN $7.81 $7.81 – $7.81 54 1
Lewistown, MT $18.67 $0.00 – $36.15 54 3
Elmwood, IL $7.04 $7.04 – $7.04 54 1
Jbsa Lackland, TX $0.00 $0.00 – $0.00 54 1
Thermopolis, WY $2.67 $0.00 – $3.79 54 2
North Tonawanda, NY $7.67 $7.67 – $7.67 55 1
Northfield, OH $0.00 $0.00 – $0.00 55 1
South Salt Lake, UT $14.17 $14.17 – $14.17 55 1
Basin, WY $7.44 $0.00 – $9.98 55 2

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.