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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
Rockford, IL $32.74 $-1.61 – $122.27 153,601 82
Seattle, WA $11.75 $0.00 – $73.38 154,283 114
Hialeah, FL $6.25 $0.00 – $75.22 159,202 63
Riverside, CA $32.40 $0.00 – $146.82 161,410 47
Parma, OH $13.95 $0.41 – $28.83 165,570 64
Tulsa, OK $19.47 $3.44 – $62.61 165,995 61
Richland, MS $30.95 $20.44 – $115.67 168,713 4
Rockville, MD $31.81 $5.81 – $91.95 172,324 55
Lexington, KY $8.77 $0.00 – $73.14 172,652 97
Chester, VA $18.88 $0.08 – $28.11 173,013 16
Mesa, AZ $38.36 $0.00 – $72.12 173,922 63
Bradenton, FL $6.36 $0.00 – $40.93 174,390 61
Lubbock, TX $10.12 $0.00 – $37.75 179,345 54
Wilmington, NC $11.97 $0.00 – $66.38 179,556 75
Wichita, KS $6.82 $0.24 – $38.99 180,368 106
Columbia, MD $22.07 $0.00 – $78.11 181,219 44
Lake Mary, FL $17.56 $0.45 – $78.15 184,169 39
Farmington, CT $15.14 $0.00 – $50.94 184,269 47
Boston, MA $13.23 $0.53 – $58.25 185,676 116
Pittsburgh, PA $17.82 $0.00 – $59.77 186,338 141
Melbourne, FL $6.25 $0.00 – $124.18 188,982 76
Lakeland, FL $6.01 $0.00 – $35.86 199,921 53
Irvine, CA $15.60 $0.00 – $69.47 200,937 37
Norfolk, VA $15.50 $0.00 – $111.84 201,218 117
Shreveport, LA $7.55 $0.00 – $27.65 201,835 67
Clearwater, FL $6.96 $0.00 – $27.25 205,762 87
Columbia, SC $16.14 $0.00 – $70.12 206,406 141
Dunedin, FL $6.64 $0.15 – $71.20 206,431 25
Albuquerque, NM $42.76 $0.00 – $125.32 207,906 151
Toledo, OH $17.41 $0.00 – $48.42 208,043 102
Vicksburg, MS $34.77 $0.00 – $102.70 218,574 20
Atlanta, GA $11.13 $0.00 – $49.13 221,828 48
Flushing, NY $14.44 $0.00 – $70.05 225,246 54
Fort Myers, FL $5.28 $0.00 – $56.98 234,013 88
Pensacola, FL $15.05 $0.00 – $86.02 234,998 72
Washington, DC $27.03 $0.00 – $103.76 237,041 117
Van Nuys, CA $30.33 $2.09 – $39.05 243,035 22
Johnson City, TN $9.59 $0.00 – $34.94 243,361 73
Sherman Oaks, CA $21.07 $0.00 – $32.92 244,396 36
Canton, OH $11.21 $0.54 – $26.76 248,952 69
Lafayette, LA $6.08 $0.00 – $23.22 249,068 60
Ocala, FL $4.57 $0.00 – $52.03 249,508 69
Austin, TX $8.15 $0.00 – $43.56 264,498 198
Richmond, VA $16.25 $0.00 – $83.82 267,829 139
Oklahoma City, OK $19.63 $5.25 – $46.39 267,871 110
Staten Island, NY $10.88 $0.00 – $69.24 271,406 96
St Petersburg, FL $10.42 $0.00 – $60.12 272,919 90
Scottsdale, AZ $43.09 $0.00 – $378.84 273,936 83
Concord, NC $17.76 $0.00 – $38.30 283,703 109
Nashville, TN $14.27 $0.00 – $380.00 290,550 155

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.