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 — 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 |
|---|---|---|---|---|
| Marks, MS | $26.59 | $18.62 – $49.01 | 20,210 | 3 |
| Rockingham, NC | $16.23 | $0.00 – $19.83 | 20,250 | 4 |
| Huntington Beach, CA | $10.67 | $0.00 – $46.79 | 20,275 | 19 |
| Fairmont, WV | $14.06 | $2.01 – $28.65 | 20,283 | 14 |
| East Falmouth, MA | $8.94 | $5.27 – $24.14 | 20,304 | 3 |
| Summerville, SC | $16.15 | $5.25 – $60.33 | 20,310 | 15 |
| Sebring, FL | $5.64 | $0.50 – $10.93 | 20,310 | 9 |
| Wytheville, VA | $6.91 | $2.35 – $10.05 | 20,316 | 3 |
| East Longmeadow, MA | $15.73 | $7.25 – $21.58 | 20,331 | 5 |
| West Chester, OH | $11.37 | $0.09 – $22.05 | 20,380 | 13 |
| N Chelmsford, MA | $12.78 | $11.50 – $16.32 | 20,403 | 3 |
| Opelousas, LA | $4.66 | $0.00 – $9.95 | 20,423 | 11 |
| Gray, GA | $2.53 | $1.22 – $3.43 | 20,431 | 2 |
| Winnsboro, LA | $0.59 | $0.00 – $19.77 | 20,438 | 6 |
| Ft Lauderdale, FL | $5.40 | $0.00 – $76.02 | 20,447 | 10 |
| Florissant, MO | $16.01 | $0.00 – $29.24 | 20,451 | 11 |
| Hilliard, OH | $12.00 | $8.45 – $16.43 | 20,453 | 7 |
| Wheelersburg, OH | $7.30 | $2.35 – $11.37 | 20,468 | 7 |
| Harrisonburg, VA | $13.68 | $5.67 – $40.98 | 20,486 | 10 |
| Gary, IN | $17.03 | $3.13 – $34.63 | 20,526 | 13 |
| Lexington, SC | $22.47 | $8.91 – $75.95 | 20,558 | 16 |
| Freehold, NJ | $11.18 | $0.15 – $35.45 | 20,563 | 22 |
| Tarzana, CA | $34.43 | $2.38 – $571.66 | 20,627 | 15 |
| Marianna, FL | $8.61 | $2.93 – $44.76 | 20,685 | 19 |
| Fort Smith, AR | $21.19 | $6.35 – $87.42 | 20,714 | 23 |
| Holmdel, NJ | $24.03 | $3.08 – $57.36 | 20,717 | 12 |
| Anthem, AZ | $32.52 | $19.74 – $49.87 | 20,723 | 5 |
| Glenview, IL | $12.04 | $1.12 – $57.27 | 20,759 | 21 |
| Maitland, FL | $5.61 | $0.00 – $15.79 | 20,830 | 12 |
| Westport, MA | $11.97 | $11.01 – $24.30 | 20,882 | 2 |
| Sylva, NC | $7.74 | $1.96 – $29.47 | 20,888 | 7 |
| Marion, VA | $8.41 | $5.86 – $19.95 | 20,906 | 6 |
| Mcminnville, TN | $28.29 | $0.00 – $32.17 | 20,934 | 6 |
| Fairfield, CT | $20.45 | $0.15 – $43.37 | 20,953 | 11 |
| Sleepy Hollow, NY | $2.94 | $0.00 – $7.04 | 20,982 | 3 |
| Chillicothe, OH | $11.81 | $3.53 – $34.14 | 20,986 | 20 |
| Brighton, MA | $12.30 | $1.02 – $36.21 | 21,037 | 9 |
| Union City, NJ | $15.96 | $4.37 – $25.11 | 21,083 | 13 |
| Center Valley, PA | $26.74 | $0.00 – $39.06 | 21,084 | 26 |
| Oak Ridge, TN | $11.52 | $1.83 – $37.77 | 21,099 | 9 |
| Panorama City, CA | $12.20 | $0.36 – $20.49 | 21,103 | 16 |
| Pleasantville, NJ | $32.87 | $0.48 – $52.02 | 21,110 | 13 |
| Woodland Hills, CA | $22.92 | $0.00 – $61.64 | 21,171 | 17 |
| Chambersburg, PA | $21.54 | $0.00 – $38.88 | 21,223 | 13 |
| Spanish Fort, AL | $3.58 | $0.89 – $11.35 | 21,249 | 5 |
| Gretna, LA | $5.38 | $0.00 – $16.34 | 21,259 | 11 |
| Harlingen, TX | $6.75 | $0.00 – $23.56 | 21,269 | 15 |
| Garland, TX | $4.69 | $2.02 – $31.44 | 21,285 | 11 |
| Waltham, MA | $14.67 | $0.00 – $44.17 | 21,336 | 13 |
| Circleville, OH | $15.10 | $8.81 – $28.27 | 21,355 | 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.