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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
Airmont, NY $14.72 $10.99 – $19.88 13,246 2
Midlothian, TX $4.87 $0.23 – $5.08 13,247 2
Savannah, TN $4.11 $0.16 – $13.12 13,265 9
Oxford, MS $10.56 $0.00 – $211.63 13,269 8
Lockport, LA $1.58 $1.58 – $1.58 13,270 1
Charleston, MS $19.57 $18.27 – $33.04 13,278 3
Lebanon, VA $9.00 $3.37 – $21.14 13,298 6
Hamilton, NJ $20.68 $0.43 – $72.77 13,303 10
Reading, PA $22.23 $0.13 – $37.76 13,303 11
Sandwich, IL $14.44 $14.15 – $14.57 13,303 2
Mullica Hill, NJ $37.43 $0.00 – $43.88 13,360 7
Timonium, MD $39.28 $0.00 – $81.93 13,370 6
Ashland, OH $8.65 $0.00 – $16.12 13,389 10
Johns Creek, GA $4.54 $0.00 – $25.07 13,390 4
Tinton Falls, NJ $19.25 $2.72 – $37.99 13,393 9
Charles Town, WV $9.80 $2.01 – $13.46 13,400 6
Sandy Hook, CT $20.36 $18.36 – $20.77 13,405 3
Nashville, AR $16.97 $16.04 – $21.76 13,406 3
Sylvania, OH $13.38 $2.83 – $21.21 13,418 11
Avon Park, FL $5.19 $2.98 – $9.61 13,438 6
Santa Maria, CA $11.47 $0.00 – $40.06 13,439 13
Sumter, SC $18.66 $0.00 – $40.37 13,442 10
Plaquemine, LA $5.45 $5.45 – $5.45 13,450 1
Poteau, OK $45.34 $16.23 – $68.52 13,454 5
Lexington, TN $9.05 $5.82 – $34.05 13,455 9
Alamo, TN $17.99 $9.49 – $18.13 13,459 3
El Centro, CA $11.22 $1.43 – $36.35 13,476 7
Arlington Heights, IL $13.17 $1.64 – $36.90 13,486 18
Burgaw, NC $12.75 $9.82 – $17.62 13,498 5
Lexington, VA $11.94 $10.92 – $11.98 13,522 2
Pilot Knob, MO $49.33 $23.67 – $57.77 13,532 4
Clinton, LA $8.01 $0.00 – $8.48 13,541 2
Keene, NH $7.91 $0.00 – $34.62 13,589 20
Sylacauga, AL $13.36 $2.03 – $16.71 13,612 4
Brookfield, WI $19.98 $6.73 – $25.01 13,643 13
Carmel, NY $5.97 $0.00 – $22.61 13,653 5
Hampton, VA $13.47 $0.09 – $22.08 13,701 22
Greenwood, MS $14.77 $7.93 – $87.40 13,713 6
Centreville, VA $11.75 $11.18 – $25.19 13,715 4
Buffalo Grove, IL $4.37 $2.02 – $12.86 13,725 8
Rockaway, NJ $21.44 $9.33 – $25.19 13,746 4
Castlewood, VA $9.15 $9.15 – $9.15 13,774 1
Jasper, AL $3.25 $0.00 – $24.18 13,797 11
Newton, NC $13.17 $10.39 – $73.78 13,836 6
Muscle Shoals, AL $3.77 $1.17 – $8.77 13,854 8
Rockville, IN $6.26 $5.70 – $6.94 13,855 3
Lexington, OK $23.61 $23.61 – $23.61 13,881 1
Wasilla, AK $42.39 $0.00 – $93.05 13,924 13
Bedford, NH $4.51 $0.42 – $7.33 13,925 10
Kyle, TX $2.67 $0.00 – $2.80 13,940 5

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.