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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
Southold, NY $5.81 $0.00 – $25.92 339 2
Cedarhusrt, NY $3.74 $3.74 – $3.74 339 1
Taylorsville, KY $0.59 $0.59 – $0.59 340 1
Roseville, MN $54.98 $31.10 – $58.53 340 2
Yulee, FL $19.00 $19.00 – $19.00 340 1
Bay Minette, AL $8.61 $0.00 – $13.35 340 5
Two Rivers, WI $9.87 $2.19 – $16.69 341 4
Estherville, IA $5.30 $5.30 – $5.30 341 1
Hereford, TX $21.04 $21.04 – $21.04 341 1
Larkspur, CA $14.77 $14.77 – $14.77 341 1
Tumwater, WA $9.72 $3.86 – $29.32 343 3
Northampton, PA $2.95 $2.95 – $2.95 343 1
Dumas, AR $6.77 $6.77 – $6.77 343 1
Caldwell, NJ $9.26 $9.26 – $9.26 343 1
Refugio, TX $40.11 $40.11 – $40.11 344 1
Rolling Fork, MS $13.61 $0.00 – $20.17 345 3
Commerce, CA $25.06 $25.06 – $25.06 345 1
Dixon, IL $11.90 $0.00 – $26.54 346 5
Buckley, WA $39.89 $39.89 – $39.89 346 1
Congers, NY $5.25 $5.25 – $5.25 346 1
Sharonville, OH $8.93 $8.93 – $8.93 346 1
Swan, IA $5.72 $5.72 – $5.72 346 1
Middlebury, VT $13.78 $10.16 – $18.72 347 4
Bermuda Run, NC $24.75 $24.75 – $24.75 347 1
Long Grove, IA $5.14 $5.14 – $5.14 347 1
King City, CA $2.41 $1.28 – $14.33 347 2
Murphysboro, IL $2.08 $0.00 – $2.78 347 2
Fayetteville, PA $2.98 $2.98 – $2.98 347 1
Wakefield, MI $20.59 $0.00 – $76.84 347 2
West Jefferson, OH $8.29 $8.29 – $8.29 348 1
Louisa, VA $16.32 $16.32 – $16.32 348 1
Rockport, AR $23.40 $23.40 – $23.40 348 1
Marion, IL $5.47 $1.07 – $14.86 349 3
Coffeyville, KS $59.72 $59.72 – $59.72 349 1
Roselle, IL $47.57 $47.57 – $47.57 349 1
Greenwood, AR $23.93 $15.87 – $24.29 349 2
Tiffin, IA $8.15 $8.15 – $8.15 350 1
North Providence, RI $24.53 $4.70 – $36.27 351 4
Mt Sterling, IL $0.00 $0.00 – $0.00 351 1
Tatum, TX $8.04 $8.04 – $8.04 351 1
Cove, AR $26.74 $26.74 – $26.74 351 1
Independence, KS $10.91 $10.91 – $10.91 352 1
Waynesboro, PA $9.55 $1.87 – $27.87 353 4
Belle Fourche, SD $21.02 $21.02 – $21.02 353 1
Toccoa, GA $3.96 $3.96 – $3.96 354 1
Freemansburg, PA $16.92 $16.92 – $16.92 356 1
Cedaredge, CO $8.80 $7.77 – $10.96 359 2
Lake Andes, SD $45.56 $45.56 – $45.56 361 1
Roundup, MT $0.15 $0.00 – $4.03 361 2
Little Ferry, NJ $8.45 $8.45 – $8.45 361 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.