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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
Alhambra, CA $16.38 $3.82 – $29.31 72,858 31
Brandon, FL $5.26 $0.00 – $39.18 73,127 29
Arlington, TX $7.15 $0.00 – $27.44 73,291 31
Hendersonville, NC $18.89 $0.00 – $50.74 73,686 35
Waterbury, CT $19.19 $0.74 – $42.18 73,922 39
Norwalk, CT $17.54 $0.00 – $32.25 74,212 22
Palos Heights, IL $9.03 $1.25 – $44.25 74,468 18
Youngstown, OH $14.17 $0.00 – $61.65 74,636 45
Westchester, IL $19.60 $1.96 – $21.91 74,946 8
Yonkers, NY $11.52 $0.60 – $63.91 75,172 39
Corona, CA $35.36 $0.00 – $83.72 75,346 22
Portland, OR $21.29 $0.00 – $61.72 75,859 60
Naples, FL $7.47 $0.00 – $70.13 76,196 56
El Paso, TX $12.32 $0.00 – $45.99 76,242 62
Pasadena, MD $27.40 $0.00 – $146.42 76,307 13
Kansas City, MO $17.12 $0.00 – $113.53 76,811 71
Anaheim, CA $16.30 $0.00 – $52.00 76,851 38
Saint Petersburg, FL $3.94 $0.00 – $18.39 76,925 22
Greenville, SC $17.56 $0.00 – $77.31 77,023 75
Boerne, TX $9.63 $1.01 – $22.88 77,145 28
Pomona, CA $15.96 $0.00 – $100.53 77,180 39
Redlands, CA $20.07 $0.00 – $68.60 77,673 14
El Segundo, CA $21.30 $0.00 – $46.68 77,992 22
Petersburg, VA $47.28 $2.41 – $85.50 78,407 17
Batesville, MS $36.33 $0.00 – $52.10 78,439 10
Evanston, IL $11.42 $0.00 – $52.06 78,976 18
Hopewell, VA $43.17 $3.01 – $70.96 79,330 12
Strongsville, OH $18.98 $5.64 – $31.07 79,853 17
Linwood, NJ $23.57 $2.64 – $36.61 79,930 10
Clermont, FL $9.17 $0.29 – $31.08 80,077 22
Laurel, MD $41.24 $0.00 – $75.64 80,910 27
Brighton, MI $36.26 $36.26 – $36.26 81,323 1
Great Neck, NY $9.13 $0.00 – $23.44 81,370 9
Carmel, IN $10.28 $0.00 – $27.67 81,928 30
Katy, TX $7.85 $0.00 – $45.73 82,453 43
Naperville, IL $13.20 $3.29 – $47.31 82,800 26
Port Orange, FL $4.37 $0.00 – $43.38 83,128 11
Cuyahoga Falls, OH $10.59 $1.79 – $25.87 83,778 18
Shelton, CT $26.93 $2.02 – $49.70 84,063 19
Avon, CT $17.23 $0.00 – $38.88 84,213 22
Hyattsville, MD $34.24 $0.00 – $75.09 84,236 15
Jacksboro, TX $8.66 $0.00 – $8.73 84,318 3
Sugar Land, TX $9.10 $0.00 – $38.72 84,608 58
Springfield, MO $27.03 $0.00 – $69.24 84,700 40
Sand Springs, OK $16.52 $2.35 – $23.92 84,834 5
Waukesha, WI $21.56 $4.10 – $36.38 85,079 49
Torrance, CA $14.33 $1.98 – $67.30 85,193 47
Elmhurst, NY $11.87 $3.95 – $77.74 85,361 19
Lynchburg, VA $10.05 $3.03 – $26.90 85,902 43
Riverwoods, IL $28.84 $8.20 – $36.25 86,974 6

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.