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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
Portland, TX $3.00 $0.00 – $3.16 235 2
Milledgeville, GA $21.31 $21.31 – $21.31 236 1
Philipsburg, PA $6.54 $0.00 – $7.87 236 2
Granville, NY $12.67 $12.67 – $12.67 236 1
Vona, CO $12.90 $12.90 – $12.90 236 1
Red Bud, IL $11.17 $11.17 – $11.17 237 1
Sterling, CO $22.82 $22.82 – $22.82 237 1
De Queen, AR $22.57 $20.63 – $56.19 237 3
Jericho, VT $17.37 $17.37 – $17.37 237 1
Hillsboro, WI $58.05 $58.05 – $58.05 237 1
Brunswick, GA $2.15 $2.15 – $2.15 238 1
Ranshaw, PA $0.62 $0.62 – $0.62 238 1
Satellite Beach, FL $0.00 $0.00 – $0.00 238 1
Plainfield, CT $18.24 $8.79 – $19.06 239 2
Spiro, OK $16.77 $16.77 – $16.77 239 1
Orange, VA $4.07 $4.07 – $4.07 239 1
Canton, SD $27.31 $27.31 – $27.31 239 1
Spencerville, OH $6.94 $6.94 – $6.94 239 1
Baldwin, NY $3.11 $0.48 – $11.72 240 2
Keyser, WV $18.46 $16.14 – $22.25 240 2
Callicoon, NY $7.69 $7.69 – $7.69 240 1
Mickleton, NJ $3.78 $3.78 – $3.78 240 1
Taylorsville, MS $19.32 $19.32 – $19.32 240 1
Boonton Twp, NJ $16.35 $16.35 – $16.35 240 1
Southampton, PA $5.85 $5.85 – $5.85 241 1
South Ogden, UT $45.86 $12.57 – $49.89 241 2
Argyle, TX $2.45 $2.45 – $2.45 242 1
Cornelius, NC $4.81 $3.68 – $14.61 242 2
Gothenburg, NE $32.66 $32.66 – $32.66 242 1
Centreville, MS $19.90 $0.00 – $21.89 242 2
Carthage, NC $10.91 $10.91 – $10.91 243 1
Blackville, SC $19.69 $19.69 – $19.69 243 1
Richfield, UT $28.52 $28.52 – $28.52 244 2
East Palatka, FL $6.03 $6.03 – $6.03 244 1
Oakton, VA $4.02 $3.32 – $12.37 244 2
Georgetown, IL $36.35 $36.35 – $36.35 244 1
Hennessey, OK $16.55 $16.55 – $16.55 245 1
Sharon Hill, PA $5.01 $2.95 – $8.96 245 2
Lake Crystal, MN $53.31 $53.31 – $53.31 245 1
Cedarville, CA $2.74 $2.74 – $2.74 245 1
Virginia, MN $71.40 $60.55 – $259.35 246 3
Bunkie, LA $0.00 $0.00 – $0.00 246 2
Jaffrey, NH $11.86 $11.86 – $11.86 246 1
Bonham, TX $2.86 $1.57 – $7.93 246 2
Dania Beach, FL $15.25 $15.25 – $15.25 246 1
Upper Chichester, PA $24.58 $8.05 – $33.94 246 2
Atlantic, IA $5.95 $0.00 – $22.30 247 6
Mount Olive, MS $23.31 $23.31 – $23.31 247 1
Stillwater, OK $15.23 $12.21 – $17.98 248 2
Apple Valley, MN $24.09 $24.09 – $24.09 248 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.