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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
Cherryville, NC $12.99 $10.23 – $19.03 15,272 3
Cortlandt Manor, NY $11.43 $0.00 – $62.95 15,275 5
Fontana, CA $29.12 $0.00 – $51.50 15,285 13
Du Bois, PA $15.76 $0.00 – $30.38 15,289 12
Jefferson, NC $8.52 $8.46 – $24.32 15,313 4
Galloway, NJ $15.29 $0.55 – $32.46 15,320 14
Pennington, NJ $12.32 $4.34 – $21.46 15,322 8
Northampton, MA $14.09 $9.40 – $65.52 15,330 6
Lawrenceville, NJ $19.36 $6.26 – $25.41 15,334 8
Arverne, NY $16.20 $10.50 – $17.38 15,349 2
Dallas, GA $11.32 $11.32 – $11.32 15,375 1
Winchester, VA $10.99 $0.00 – $86.50 15,397 25
Maryville, IL $8.30 $0.00 – $28.04 15,400 15
Anderson, SC $18.70 $0.00 – $36.89 15,412 14
Mokena, IL $28.04 $5.48 – $32.27 15,439 5
Medford, OR $15.11 $0.00 – $49.43 15,454 15
Anchorage, AK $68.17 $0.00 – $143.58 15,485 37
Long Grove, IL $13.35 $2.11 – $40.05 15,485 9
Berwyn, IL $23.21 $0.35 – $33.41 15,493 12
Cleveland, TX $7.53 $3.80 – $7.60 15,498 2
Humansville, MO $51.68 $51.48 – $52.15 15,508 2
Monterey Park, CA $23.01 $0.00 – $50.58 15,520 22
Troup, TX $15.47 $8.70 – $30.47 15,528 2
Maplewood, NJ $15.74 $1.71 – $33.61 15,545 10
Ridgewood, NJ $3.53 $0.04 – $67.50 15,580 10
Rapid City, SD $19.56 $5.92 – $39.59 15,581 7
Jamaica Plain, MA $8.67 $4.25 – $24.82 15,587 7
Bolingbrook, IL $25.58 $0.32 – $54.51 15,608 17
Rocklin, CA $10.29 $0.00 – $19.98 15,617 3
Fort Campbell, KY $8.58 $2.38 – $19.11 15,625 4
Ft Pierce, FL $15.31 $15.31 – $15.31 15,637 1
West Chester, PA $13.53 $0.25 – $26.14 15,653 14
Spokane Valley, WA $12.29 $1.97 – $39.16 15,653 11
Cheyenne, WY $16.12 $6.53 – $25.33 15,661 9
Leesburg, VA $7.43 $1.80 – $28.58 15,661 16
New Albany, OH $10.67 $5.03 – $14.27 15,672 4
Santa Fe, NM $35.71 $1.83 – $48.05 15,676 13
Bettendorf, IA $8.81 $0.21 – $13.90 15,700 12
Lakewood, WA $14.63 $0.00 – $43.12 15,737 15
Saint Joseph, MI $13.34 $7.76 – $55.32 15,757 5
Sandy, UT $26.97 $13.05 – $89.52 15,765 9
Palmyra, NJ $23.45 $23.45 – $23.45 15,785 1
Brookville, IN $14.80 $7.34 – $18.42 15,825 2
Fulton, IL $5.61 $3.55 – $7.68 15,825 2
Hot Springs Village, AR $18.73 $18.32 – $20.29 15,836 4
Braintree, MA $15.40 $2.13 – $20.40 15,864 7
Sherman, TX $4.32 $0.27 – $61.25 15,912 12
Moorestown, NJ $10.73 $6.25 – $17.83 15,921 8
Davenport, FL $11.53 $0.00 – $16.38 15,929 9
Layton, UT $27.74 $16.28 – $77.42 15,929 11

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.