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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
Reston, VA $15.33 $4.92 – $53.08 11,011 13
Wiggins, MS $19.22 $2.39 – $34.38 11,015 7
Nahant, MA $8.80 $8.80 – $8.80 11,017 1
Hicksville, NY $5.50 $0.00 – $15.36 11,036 5
Fewtus, MO $19.28 $19.28 – $19.28 11,037 1
Winfield, AL $4.38 $0.00 – $12.39 11,044 6
Bogalusa, LA $3.02 $1.34 – $15.97 11,048 9
Tallassee, AL $11.81 $0.00 – $13.62 11,049 3
Erlanger, KY $13.50 $3.64 – $15.48 11,083 4
Midwest City, OK $18.32 $7.96 – $41.35 11,111 10
Lawrenceville, VA $7.67 $5.74 – $7.79 11,125 2
Maricopa, AZ $52.90 $3.95 – $53.11 11,137 2
Monticello, MS $13.81 $10.86 – $34.45 11,171 5
Beloit, WI $12.24 $4.58 – $13.50 11,215 7
Punta Gorda, FL $2.45 $2.01 – $5.98 11,221 3
Weatherford, TX $7.28 $0.41 – $21.61 11,222 9
Templeton, CA $0.71 $0.31 – $0.80 11,231 2
Brazil, IN $5.29 $1.28 – $13.93 11,235 8
Montgomeryville, PA $16.52 $7.70 – $27.16 11,249 4
Wake Forest, NC $30.59 $0.00 – $57.55 11,272 8
Mayfield Village, OH $11.62 $7.63 – $28.04 11,307 6
Westmont, IL $9.47 $1.33 – $50.48 11,313 7
Middlefield, OH $15.87 $15.39 – $16.32 11,315 2
Perrysburg, OH $13.26 $4.70 – $37.31 11,317 20
Louisa, KY $5.02 $2.39 – $9.14 11,333 7
Grundy, VA $15.13 $7.27 – $16.67 11,342 4
Winsted, CT $15.32 $15.32 – $15.32 11,343 1
Brandon, MS $36.99 $9.20 – $108.24 11,356 10
Richmond Heights, OH $19.12 $10.49 – $22.66 11,369 4
Bethesda, MD $28.57 $0.00 – $66.77 11,411 8
Gooding, ID $20.07 $2.20 – $29.89 11,432 3
East Meadow, NY $13.01 $2.76 – $54.30 11,484 13
Oakdale, LA $2.84 $2.51 – $4.39 11,485 2
San Pedro, CA $14.23 $3.45 – $50.52 11,489 9
National City, CA $15.79 $0.08 – $114.54 11,494 22
Grapevine, TX $11.41 $0.00 – $73.82 11,502 10
Sun City, AZ $29.95 $0.00 – $44.57 11,519 6
Westborough, MA $25.67 $0.86 – $35.29 11,525 6
Nampa, ID $29.44 $15.08 – $92.94 11,566 9
Landover, MD $10.79 $4.89 – $11.97 11,568 2
Uncasville, CT $7.39 $6.41 – $7.58 11,584 2
Duluth, MN $39.93 $3.12 – $101.65 11,602 29
Pickerington, OH $15.23 $1.72 – $21.09 11,605 8
Martin, TN $18.45 $7.67 – $32.03 11,606 4
Wilburton, OK $46.62 $5.72 – $46.96 11,650 3
Fernandina Beach, FL $5.19 $3.34 – $27.91 11,673 5
Cordova, TN $9.18 $0.00 – $15.76 11,673 10
Greenville, OH $2.76 $0.00 – $12.42 11,689 13
West Bloomfield, MI $29.91 $20.88 – $65.92 11,692 5
Kinston, NC $13.65 $3.87 – $19.75 11,700 9

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.