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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
Rio Rancho, NM $39.45 $20.82 – $73.65 35,885 13
Madison, MS $26.23 $0.00 – $85.54 35,956 13
Gadsden, AL $5.78 $0.00 – $36.64 35,960 16
Mckinney, TX $11.99 $0.00 – $56.66 36,216 25
Frankfort, IL $13.62 $0.00 – $28.59 36,279 7
Blue Springs, MO $14.15 $2.20 – $37.08 36,339 26
Cambridge, MA $15.26 $1.15 – $59.77 36,522 22
Des Moines, IA $8.76 $0.83 – $34.63 36,531 40
Maywood, CA $12.93 $12.76 – $12.99 36,696 2
Flowood, MS $17.67 $0.00 – $114.09 36,702 29
Little Neck, NY $7.82 $1.83 – $7.92 36,953 2
Boaz, AL $2.54 $0.00 – $5.29 36,961 9
Huber Heights, OH $23.45 $4.61 – $23.56 37,121 3
New London, CT $23.20 $4.35 – $41.14 37,229 12
Munster, IN $13.34 $0.00 – $33.12 37,583 20
Berkeley, CA $27.74 $0.00 – $131.94 37,606 18
Smithtown, NY $7.25 $0.13 – $30.20 37,707 15
Lincoln, NE $21.56 $4.82 – $72.68 37,714 42
Aventura, FL $7.18 $0.00 – $11.88 37,747 14
Canfield, OH $11.35 $5.89 – $12.21 37,794 6
Lafayette, IN $10.32 $4.88 – $24.33 37,919 26
South Windsor, CT $32.62 $15.10 – $39.11 38,026 7
Cedar Rapids, IA $13.55 $0.00 – $34.40 38,045 26
Garfield Heights, OH $13.60 $3.11 – $38.73 38,143 8
Grand Prairie, TX $6.23 $0.33 – $24.42 38,318 11
West Hartford, CT $22.15 $0.00 – $33.68 38,434 22
Morristown, TN $9.18 $2.05 – $17.30 38,546 17
Athens, OH $13.34 $2.16 – $20.86 38,681 9
Lebanon, IN $9.19 $5.74 – $33.64 38,682 14
Lakeview, MI $45.88 $0.00 – $45.90 38,682 2
Peoria, AZ $30.64 $0.00 – $58.63 38,694 20
Carrollton, TX $14.49 $0.00 – $34.22 38,780 10
Georgetown, TX $3.34 $0.00 – $25.20 38,859 11
Horsham, PA $21.82 $0.52 – $37.42 39,013 26
Albertville, AL $6.99 $0.00 – $10.82 39,113 8
Denham Springs, LA $8.54 $4.70 – $20.06 39,230 4
Chicago Ridge, IL $21.97 $20.01 – $56.85 39,258 6
Cleveland, TN $9.03 $2.14 – $24.24 39,422 17
Desoto, TX $7.90 $0.00 – $12.18 39,508 10
Dandridge, TN $18.06 $1.27 – $23.87 39,557 7
New Iberia, LA $5.67 $0.00 – $12.89 39,582 8
Melville, NY $12.61 $3.77 – $18.84 39,600 3
Highland Park, IL $14.30 $0.00 – $32.85 39,685 17
Sunrise, FL $7.42 $0.00 – $53.51 39,712 23
Milford, CT $19.07 $0.06 – $58.23 39,718 15
Gore, OK $34.26 $22.13 – $56.35 39,791 3
Maryville, TN $7.26 $1.01 – $11.32 39,868 21
Selma, AL $3.81 $0.00 – $18.40 39,875 13
Kokomo, IN $10.52 $0.49 – $44.81 39,952 24
Jenks, OK $12.32 $7.16 – $14.19 40,158 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.