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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
Horseshoe Bay, TX $10.29 $5.75 – $50.10 176 2
Morrisdale, PA $14.60 $14.60 – $14.60 176 1
Presque Isle, ME $16.40 $0.00 – $33.17 177 4
Clear Lake, IA $5.64 $5.64 – $5.64 177 1
Queen City, MO $24.19 $24.19 – $24.19 177 1
Coralville, IA $12.66 $12.66 – $12.66 178 1
Russell, KS $78.71 $5.92 – $85.90 178 2
Canton, GA $8.77 $0.00 – $11.04 178 3
Sykesville, MD $27.88 $27.88 – $27.88 178 1
Chelsea, MI $5.10 $5.10 – $5.10 178 1
Dawson, MN $343.97 $339.08 – $411.94 179 2
Jamestown, OH $19.70 $13.93 – $22.76 179 2
New Franklin, OH $6.88 $6.88 – $6.88 179 1
Waynoka, OK $33.29 $33.29 – $33.29 180 1
Belmond, IA $2.08 $0.00 – $11.68 180 2
Carlyle, IL $9.98 $9.98 – $9.98 180 1
Stratford, IA $41.13 $41.13 – $41.13 180 1
Lagrange, GA $43.00 $24.93 – $50.29 181 2
Burton, MI $59.46 $59.46 – $59.46 181 1
Margaretville, NY $0.00 $0.00 – $0.00 181 1
Marana, AZ $32.32 $29.52 – $39.07 182 4
Blue Hill, ME $19.15 $19.15 – $19.15 182 1
Greenville, KY $1.62 $1.62 – $1.62 182 1
Muldrow, OK $18.26 $18.26 – $18.26 182 1
Montour Falls, NY $13.55 $11.68 – $15.27 182 2
Adrian, MI $11.05 $11.05 – $11.05 183 1
N Miami Beach, FL $3.79 $3.79 – $3.79 183 1
Tompkinsville, KY $5.93 $5.57 – $6.59 183 2
Beaver, OK $58.35 $58.35 – $58.35 183 1
Apollo Beach, FL $12.66 $5.29 – $14.46 183 3
Valley Center, CA $9.74 $9.74 – $9.74 184 1
Mount Olive, NC $0.00 $0.00 – $0.00 184 1
Peckville, PA $16.98 $16.98 – $16.98 185 1
Hilton Head Island, SC $45.94 $4.89 – $52.01 186 3
Russell, KY $8.59 $8.59 – $8.59 186 1
Tulare, CA $13.93 $0.77 – $40.00 187 3
Jerome, ID $12.93 $12.93 – $12.93 187 1
Keyport, NJ $6.21 $6.21 – $6.21 187 1
Conshohocken, PA $6.53 $6.53 – $6.53 188 1
Jeanerette, LA $1.42 $1.42 – $1.42 188 1
O Fallon, IL $15.35 $14.36 – $17.62 189 2
Mound, MN $37.01 $37.01 – $37.01 190 1
Fayetteville, TN $5.49 $5.49 – $5.49 190 1
Stanley, WI $50.85 $50.85 – $50.85 190 1
Quitman, TX $31.92 $31.92 – $31.92 190 1
Churchville, MD $8.14 $8.14 – $8.14 190 1
North Cape May, NJ $7.22 $7.22 – $7.22 190 1
Holdrege, NE $7.20 $0.00 – $13.35 191 3
Tracy City, TN $3.03 $3.03 – $3.03 191 1
Lobelville, TN $8.55 $8.55 – $8.55 191 1

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.