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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
Osborne, KS $48.98 $10.29 – $104.31 192 2
Enosburg Falls, VT $0.00 $0.00 – $0.00 192 1
Hondo, TX $20.46 $20.46 – $20.46 192 1
Jay, VT $0.65 $0.65 – $0.65 192 1
Federalsburg, MD $78.04 $78.04 – $78.04 192 1
Quanah, TX $33.20 $33.20 – $33.20 192 1
Wayne, IL $27.71 $27.71 – $27.71 192 1
Harwinton, CT $13.16 $13.16 – $13.16 193 1
Madison Heights, MI $26.84 $26.84 – $26.84 193 1
Eglin, FL $1.02 $1.02 – $1.02 193 1
Little Rock Afb, AR $15.73 $15.64 – $16.86 193 2
Radcliff, KY $1.77 $1.77 – $1.77 194 1
Immokalee, FL $3.50 $0.00 – $5.52 194 2
Mebane, NC $16.34 $16.34 – $16.34 194 1
Tillamook, OR $23.39 $23.39 – $23.39 194 1
Higginsville, MO $55.45 $55.45 – $55.45 194 1
Upper Saddle River, NJ $14.79 $14.79 – $14.79 194 1
Depew, NY $10.62 $1.27 – $18.39 195 3
Poulsbo, WA $17.62 $11.39 – $21.53 195 3
Mauston, WI $64.96 $64.96 – $64.96 196 1
Hewitt, NJ $1.20 $1.20 – $1.20 196 1
Garrison, MD $79.42 $79.42 – $79.42 196 1
Moose Lake, MN $63.93 $63.93 – $63.93 197 1
Grand Rapids, MN $31.99 $6.50 – $45.72 197 3
South El Monte, CA $27.72 $27.72 – $27.72 197 1
Cornell, WI $18.99 $18.99 – $18.99 197 1
Yanceyville, NC $20.17 $20.17 – $20.17 197 1
Crystal Springs, MS $0.00 $0.00 – $0.00 197 1
Cherryvale, KS $11.56 $2.03 – $13.26 198 2
Ash Flat, AR $19.50 $19.50 – $19.50 198 1
Fort Gregg Adams, VA $11.16 $11.16 – $11.16 199 1
Ponca, NE $43.45 $43.45 – $43.45 199 1
Shorewood, WI $14.92 $14.92 – $14.92 199 1
Santa Clara, NM $38.18 $38.18 – $38.18 199 1
Dundee, OH $6.38 $6.38 – $6.38 199 1
Renville, MN $148.73 $148.73 – $148.73 200 1
Columbus, NE $10.62 $1.07 – $24.38 201 3
Ossipee, NH $0.35 $0.35 – $0.35 201 1
Marlboro, NJ $11.25 $11.25 – $11.25 201 1
Mimbres, NM $19.77 $19.77 – $19.77 201 1
Bernalillo, NM $41.15 $41.15 – $41.15 202 1
Arcadia, LA $2.97 $2.97 – $2.97 202 1
Teutopolis, IL $4.05 $4.05 – $4.05 202 1
Ridgecrest, CA $11.46 $6.73 – $36.67 203 3
Pittsfield, IL $0.00 $0.00 – $0.00 203 1
Council Grove, KS $17.06 $2.56 – $22.50 203 3
Barling, AR $19.70 $19.55 – $21.99 204 2
Baltimore, OH $19.28 $6.52 – $21.55 205 2
Henderson, TX $27.62 $27.62 – $27.62 205 1
Chester Springs, PA $23.64 $23.64 – $23.64 205 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.