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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
Gaithersburg, MD $33.14 $2.55 – $92.40 19,282 8
Bridgeport, WV $13.63 $6.34 – $23.39 19,292 6
Ocoee, FL $5.22 $0.00 – $13.06 19,301 11
Zion, IL $20.03 $3.80 – $42.27 19,305 5
Villanova, PA $25.03 $24.60 – $25.07 19,372 2
Southbury, CT $14.91 $0.00 – $25.38 19,379 14
Haledon, NJ $19.57 $2.65 – $32.13 19,379 5
Uniontown, OH $9.12 $2.07 – $28.64 19,391 10
Stuart, FL $5.67 $0.00 – $27.15 19,405 15
Greenville, NC $21.68 $0.00 – $64.16 19,406 20
York, PA $16.21 $0.00 – $51.27 19,408 34
North Las Vegas, NV $16.97 $1.02 – $63.58 19,414 12
Ronkonkoma, NY $23.46 $0.00 – $27.42 19,441 4
Sicklerville, NJ $15.90 $0.86 – $25.57 19,458 8
Bloomingdale, IL $17.16 $4.36 – $70.47 19,471 8
Hayti, MO $27.46 $25.49 – $30.35 19,489 5
Everett, WA $12.31 $0.00 – $61.57 19,504 20
Montebello, CA $18.78 $0.00 – $48.10 19,505 19
New Albany, MS $15.32 $0.00 – $157.66 19,527 11
Springvalley, NY $0.32 $0.32 – $0.32 19,540 1
Kensington, MD $50.41 $13.04 – $68.79 19,544 2
Bardstown, KY $6.91 $0.70 – $10.05 19,567 7
Los Gatos, CA $12.75 $0.00 – $29.64 19,570 11
Mooresville, NC $16.61 $0.00 – $34.33 19,646 15
Rayville, LA $2.50 $0.00 – $29.32 19,666 9
Moreno Valley, CA $17.40 $0.00 – $37.23 19,688 11
Norristown, PA $51.36 $0.00 – $78.51 19,690 7
Penn Valley, PA $27.08 $16.05 – $39.39 19,696 4
Coral Gables, FL $5.13 $0.00 – $38.93 19,748 17
Grand Rapids, MI $34.56 $3.57 – $50.93 19,779 14
Oxnard, CA $63.98 $0.00 – $93.75 19,811 26
Vidor, TX $5.73 $5.73 – $5.73 19,816 1
Mount Dora, FL $1.74 $0.87 – $5.52 19,838 6
Leawood, KS $10.57 $0.00 – $30.66 19,847 21
Charleston, SC $25.04 $0.00 – $50.25 19,862 31
Fort Collins, CO $11.83 $0.65 – $20.05 19,884 31
Dedham, MA $13.20 $6.19 – $36.21 19,895 6
Whitesburg, KY $19.75 $0.00 – $104.09 19,915 9
Umatilla, FL $6.58 $5.83 – $8.05 19,992 2
La Follette, TN $8.68 $2.98 – $12.72 20,020 7
Merced, CA $22.22 $0.66 – $31.92 20,024 7
San Angelo, TX $5.56 $1.15 – $12.10 20,029 10
Dyer, IN $10.81 $0.00 – $45.21 20,057 11
Harrisonville, MO $19.39 $18.99 – $28.98 20,070 2
Rolla, MO $38.82 $17.36 – $67.62 20,081 7
North Royalton, OH $12.14 $11.32 – $19.98 20,106 4
Jacksboro, TN $29.28 $2.89 – $36.36 20,134 6
Albany, NY $8.39 $0.00 – $39.88 20,157 30
Tullahoma, TN $12.35 $0.00 – $27.58 20,191 15
Dublin, VA $11.09 $8.36 – $13.08 20,193 3

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.