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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
Kings Park, NY $28.38 $26.15 – $28.47 884 2
Hunter, NY $5.13 $5.13 – $5.13 884 1
Dresden, TN $7.96 $4.72 – $25.58 885 4
Bridgewater, VA $9.72 $5.62 – $15.10 885 3
Fowler, OH $19.87 $15.56 – $26.35 885 2
Winooski, VT $16.87 $16.87 – $16.87 886 1
Newcastle, OK $9.19 $9.19 – $9.19 887 1
Holden, MA $15.62 $6.62 – $25.49 887 3
South Portland, ME $19.95 $14.58 – $24.24 888 4
Menifee, CA $5.44 $4.27 – $19.91 890 2
Milton, PA $16.35 $0.00 – $57.37 892 4
Palmerton, PA $6.27 $0.80 – $7.87 897 3
Mannford, OK $17.32 $17.32 – $17.32 897 1
Farmington, UT $12.37 $11.79 – $48.94 898 2
Murchison, TX $6.36 $6.36 – $6.36 898 1
Vian, OK $20.52 $20.52 – $20.52 898 1
Socorro, NM $31.51 $31.51 – $31.51 899 1
Delta, CO $15.07 $7.45 – $16.78 900 2
Ozone Park, NY $7.47 $7.47 – $7.47 900 1
Oakdale, PA $51.02 $51.02 – $51.02 902 1
Mount Jackson, VA $21.02 $3.26 – $22.82 902 2
Montezuma, KS $7.84 $7.84 – $7.84 903 1
Blythe, CA $9.07 $3.21 – $82.21 903 2
Tamuning, GU $18.59 $17.01 – $88.77 906 3
Waianae, HI $38.98 $38.98 – $38.98 906 1
Nevada, MO $15.09 $2.22 – $66.04 907 7
Pittston, PA $23.59 $7.94 – $46.80 907 3
Downingtown, PA $11.91 $3.34 – $18.60 909 4
Silver City, NM $26.88 $12.20 – $33.04 911 6
Auburndale, FL $4.42 $4.42 – $4.42 911 1
Sullivan, IN $8.22 $0.00 – $31.37 912 5
East Greenwich, RI $7.11 $2.30 – $16.84 912 2
Kingsburg, CA $6.65 $6.65 – $6.65 912 1
Grove City, OH $9.60 $9.60 – $9.60 913 1
Wellsville, NY $5.57 $0.00 – $21.06 913 3
Glasgow, MT $2.16 $0.00 – $13.90 913 2
Macon, MO $36.54 $35.66 – $92.63 915 2
Bremen, IN $4.57 $4.57 – $4.57 915 1
Clive, IA $8.22 $1.05 – $11.97 916 5
Del City, OK $19.34 $5.67 – $26.63 916 3
Hewitt, TX $11.10 $11.10 – $11.10 916 1
Eagle River, AK $5.42 $4.45 – $19.26 918 2
Coldspring, TX $7.35 $7.35 – $7.35 918 1
Danbury, NC $3.92 $3.92 – $3.92 919 1
Ellisville, MO $17.09 $17.09 – $17.09 920 1
Forest, VA $8.05 $4.55 – $8.37 921 2
Santee, CA $18.34 $2.48 – $19.43 922 3
Milan, OH $4.07 $4.07 – $4.07 923 1
Auburn, MA $10.00 $10.00 – $10.00 925 1
Diberville, MS $18.42 $18.39 – $19.77 926 2

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.