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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
Massapequa, NY $7.27 $1.65 – $98.10 9,733 10
Richmond Hill, NY $5.38 $0.49 – $5.72 9,734 4
Weeki Wachee, FL $2.47 $2.47 – $2.47 9,740 1
Franklin, LA $8.66 $0.00 – $19.07 9,788 5
Edgewater, FL $9.06 $9.06 – $9.06 9,795 1
Vivian, LA $10.48 $0.58 – $11.09 9,797 2
Tabernacle, NJ $18.89 $18.89 – $18.89 9,808 1
Ann Arbor, MI $32.53 $7.47 – $76.48 9,812 10
Woodbury, NJ $18.35 $1.39 – $53.84 9,820 13
Palo Alto, CA $14.88 $0.00 – $23.29 9,826 12
Mason City, IA $9.60 $1.57 – $50.15 9,827 21
Charlestown, IN $9.08 $5.70 – $10.61 9,849 2
Augusta, ME $12.70 $3.37 – $29.74 9,854 11
Encinitas, CA $30.69 $10.66 – $62.43 9,855 8
Rosedale, MD $45.60 $0.00 – $70.36 9,870 13
North Olmsted, OH $14.19 $10.21 – $15.51 9,898 3
Lawrenceburg, IN $7.35 $1.38 – $10.13 9,904 7
Santa Clarita, CA $15.48 $7.74 – $28.07 9,907 7
Harrison, AR $12.75 $5.67 – $15.97 9,912 8
Mt Pleasant, TN $15.58 $15.58 – $15.58 9,914 1
Leesville, LA $3.24 $0.00 – $4.64 9,915 5
Monterey, TN $8.66 $7.95 – $9.35 9,920 3
Fort Walton Beach, FL $6.94 $0.00 – $87.90 9,921 8
Okeechobee, FL $3.05 $0.00 – $6.62 9,932 9
Armonk, NY $11.85 $11.85 – $11.85 9,935 1
Winona, MS $16.52 $0.41 – $35.46 9,938 4
Ocean Springs, MS $18.94 $0.00 – $56.25 9,943 7
Arlington, TN $8.18 $5.30 – $11.95 9,951 2
Elmira, NY $10.60 $1.28 – $22.42 9,959 9
Bay City, MI $27.72 $12.89 – $53.61 9,969 5
Lincolnwood, IL $17.22 $1.81 – $43.72 9,977 10
Palm Springs, CA $22.10 $0.00 – $68.75 9,983 17
Uniondale, NY $4.54 $3.73 – $25.49 9,986 4
Scarsdale, NY $13.87 $0.00 – $23.46 10,008 6
Arcadia, CA $18.09 $5.22 – $37.88 10,011 16
San Antonio, FL $6.16 $6.16 – $6.16 10,017 1
East Dundee, IL $11.50 $7.96 – $16.46 10,035 4
Kendallville, IN $9.33 $0.00 – $10.80 10,038 6
Takoma Park, MD $36.81 $4.81 – $61.46 10,046 10
Deerfield, IL $9.81 $2.73 – $22.15 10,049 6
Mchenry, IL $20.24 $0.00 – $22.85 10,052 9
Mt. Laurel, NJ $8.83 $8.47 – $9.73 10,064 3
Texas City, TX $5.79 $4.80 – $12.54 10,068 6
Sedona, AZ $15.49 $15.49 – $15.49 10,073 1
Dyer, TN $5.81 $5.81 – $5.81 10,084 1
Howell, NJ $14.86 $1.34 – $20.64 10,089 8
Hammonton, NJ $25.33 $1.65 – $49.86 10,091 6
Eureka, CA $53.09 $6.73 – $205.68 10,098 8
Sparta, NC $8.86 $8.68 – $11.94 10,102 2
Lowell, MA $11.11 $0.83 – $44.82 10,103 16

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.