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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
Boynton Beach, FL $6.80 $0.00 – $44.18 62,031 40
Dothan, AL $7.59 $0.10 – $73.73 62,246 18
Poughkeepsie, NY $9.26 $0.00 – $59.72 62,306 26
Fredericksburg, VA $11.57 $0.00 – $41.01 62,362 35
Raymond, MS $29.35 $29.34 – $57.12 62,630 2
Chattanooga, TN $12.98 $0.00 – $23.40 62,689 44
Winter Park, FL $5.32 $0.00 – $31.09 62,896 18
Clifton, NJ $20.59 $0.00 – $42.44 63,075 24
Rancho Cucamonga, CA $33.89 $2.11 – $54.83 63,109 19
Costa Mesa, CA $54.76 $7.61 – $58.66 63,121 10
Glendale, CA $16.20 $0.00 – $833.95 63,209 61
Montgomery, AL $5.85 $0.00 – $23.46 63,357 38
Towson, MD $27.48 $0.13 – $95.37 63,399 23
Warrensville Heights, OH $12.48 $7.89 – $22.54 63,785 19
Rocky Mount, NC $5.25 $0.00 – $20.67 63,809 18
Jamaica, NY $10.52 $0.00 – $39.90 63,814 35
Fort Lauderdale, FL $6.18 $0.00 – $42.07 63,957 32
Jersey City, NJ $12.83 $1.27 – $46.73 64,272 41
Alexandria, VA $15.74 $0.00 – $37.76 64,544 40
Northridge, CA $34.62 $2.04 – $165.95 64,704 32
Rochester, NY $7.46 $0.00 – $38.85 64,858 75
New Hyde Park, NY $13.34 $0.53 – $32.32 64,956 18
Manchester, NH $4.60 $0.00 – $10.32 65,068 31
Port Charlotte, FL $4.35 $0.00 – $13.80 65,304 35
Rego Park, NY $11.68 $2.70 – $82.36 65,371 17
Gilbert, AZ $35.41 $0.00 – $59.17 66,102 22
San Francisco, CA $32.86 $0.00 – $703.29 66,360 109
Tyler, TX $10.23 $0.00 – $30.40 66,523 36
New Smyrna Beach, FL $7.72 $0.00 – $11.80 66,683 11
Charlottesville, VA $9.32 $1.83 – $30.50 66,989 30
Salem, VA $8.35 $2.00 – $37.08 67,201 22
Warren, MI $26.93 $5.66 – $46.59 67,207 13
Haverhill, MA $13.06 $4.78 – $26.92 67,858 8
Catonsville, MD $22.10 $0.00 – $89.86 67,871 11
Burbank, CA $18.34 $0.00 – $56.82 68,113 32
Pineville, KY $102.42 $3.29 – $117.55 68,389 7
Carson, CA $24.79 $2.19 – $43.44 69,277 19
Beverly Hills, CA $20.18 $0.00 – $67.41 69,431 53
Tempe, AZ $26.32 $0.00 – $64.19 69,776 34
Bangor, ME $5.65 $0.00 – $116.31 69,909 21
New Port Richey, FL $5.64 $0.00 – $53.89 70,165 20
Plano, TX $8.55 $0.00 – $45.68 70,616 50
Redding, CA $22.97 $0.00 – $348.31 70,958 33
Bossier City, LA $10.66 $0.00 – $18.33 71,014 13
Lees Summit, MO $12.34 $0.00 – $54.11 71,297 39
Boca Raton, FL $6.43 $0.00 – $33.73 71,320 49
South Bend, IN $11.85 $0.00 – $36.77 72,408 23
Forest Hills, NY $6.00 $0.00 – $31.92 72,589 25
Edgewater, NJ $13.04 $0.00 – $28.64 72,603 7
Plymouth Meeting, PA $25.16 $0.00 – $68.39 72,828 76

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.