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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
Ft Wayne, IN $12.58 $12.58 – $12.58 18,324 1
Bolivar, TN $11.00 $6.06 – $26.87 18,332 5
Tustin, CA $11.63 $0.12 – $72.47 18,384 15
Arlington, KY $10.09 $4.43 – $10.20 18,420 2
Lawrence, NY $9.11 $1.51 – $47.50 18,423 8
Mankato, MN $58.15 $41.47 – $75.82 18,424 8
Port Arthur, TX $4.41 $0.00 – $11.63 18,429 6
Friendswood, TX $27.46 $0.00 – $32.34 18,439 7
Boardman, OH $15.06 $0.00 – $64.91 18,444 16
Montclair, NJ $7.55 $0.44 – $31.87 18,471 14
Pineland, FL $7.24 $7.24 – $7.24 18,506 1
Eden, NC $10.97 $10.03 – $22.45 18,510 4
Sparks, MD $24.86 $0.00 – $52.94 18,514 10
Lumberton, NC $12.96 $0.00 – $20.44 18,527 14
Greenwood Village, CO $31.66 $0.00 – $66.60 18,534 14
New City, NY $6.53 $3.82 – $15.34 18,544 6
Chestnut Hill, MA $7.68 $1.33 – $12.19 18,556 4
Dearborn, MI $17.24 $0.00 – $52.66 18,578 15
Lynn, MA $11.71 $4.64 – $26.07 18,588 12
Capistrano Beach, CA $3.84 $3.84 – $3.84 18,593 1
Norwich, CT $21.04 $6.37 – $41.30 18,615 13
Somerset, NJ $8.28 $2.77 – $23.41 18,624 14
Dixon, CA $13.42 $13.42 – $13.42 18,647 1
Manhasset Hills, NY $10.17 $4.71 – $14.40 18,648 4
Harrison, NY $9.36 $0.00 – $60.21 18,676 7
Torrington, CT $17.02 $0.00 – $29.76 18,679 14
Cheverly, MD $28.37 $8.21 – $71.49 18,685 8
Wheeling, IL $18.38 $4.12 – $33.40 18,706 6
Cedar Knolls, NJ $9.07 $4.29 – $25.26 18,710 21
Kingston, NY $5.36 $1.98 – $20.10 18,730 10
Niles, IL $11.22 $2.23 – $27.21 18,746 8
Hamilton Square, NJ $15.47 $5.95 – $23.38 18,767 2
Corinth, MS $13.70 $0.21 – $33.12 18,779 14
Rockwall, TX $14.28 $4.57 – $28.94 18,882 5
Lakewood, OH $18.10 $7.01 – $21.58 18,924 9
Willoughby, OH $11.61 $0.00 – $33.71 18,933 16
Hoboken, NJ $8.33 $0.00 – $27.95 18,979 10
Shavano Park, TX $13.36 $4.45 – $18.23 19,002 3
Woodstock, VA $7.95 $0.29 – $12.91 19,015 5
Fox Lake, IL $16.62 $14.79 – $17.72 19,015 2
Tinley Park, IL $14.29 $1.67 – $79.48 19,059 10
Altavista, VA $11.63 $11.63 – $11.63 19,087 1
Erwin, TN $4.54 $0.00 – $5.08 19,136 4
Germantown, MD $15.90 $0.00 – $69.59 19,157 12
Lockhart, TX $44.08 $6.17 – $49.50 19,202 5
Glen Allen, VA $11.23 $4.42 – $88.68 19,216 14
Freeport, ME $21.09 $13.79 – $42.54 19,243 12
Champaign, IL $20.25 $11.91 – $35.09 19,250 13
Glastonbury, CT $17.51 $0.00 – $31.33 19,254 14
Zachary, LA $9.60 $3.89 – $12.39 19,269 4

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.