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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
Ponte Vedra Beach, FL $4.73 $4.34 – $5.16 1,065 2
Osterville, MA $12.15 $12.15 – $12.15 1,065 1
Dawes, WV $28.92 $28.92 – $28.92 1,065 1
Redmond, WA $12.71 $5.65 – $27.82 1,066 3
Scott City, MO $9.75 $9.75 – $9.75 1,066 1
Compton, CA $11.23 $11.23 – $11.23 1,068 1
Fort Kent, ME $6.02 $6.02 – $6.02 1,069 1
Evarts, KY $50.49 $32.14 – $51.98 1,069 3
Telford, PA $16.14 $5.62 – $36.16 1,069 3
Tobyhanna, PA $20.77 $20.77 – $20.77 1,071 1
Daytona Beach Shores, FL $3.70 $3.70 – $3.70 1,071 1
Fort Liberty, NC $6.02 $6.02 – $6.02 1,072 1
Canyonville, OR $13.94 $13.94 – $13.94 1,072 1
Campbell Hall, NY $5.34 $0.17 – $8.17 1,072 2
West Amherst, NY $6.40 $4.83 – $11.18 1,074 3
El Macero, CA $17.48 $17.48 – $17.48 1,075 1
Mandan, ND $5.09 $3.86 – $21.85 1,078 2
Norcross, GA $16.55 $15.44 – $26.06 1,079 3
Jackson, CA $4.07 $0.00 – $13.27 1,079 4
Ellisville, IL $6.55 $6.55 – $6.55 1,082 1
Welsh, LA $17.63 $17.63 – $17.63 1,084 1
Midland, NC $17.46 $17.46 – $17.46 1,086 1
Montoursville, PA $16.47 $0.00 – $39.45 1,087 3
Carlsbad, NM $25.81 $3.63 – $31.16 1,089 3
Alexandria, MN $68.49 $50.49 – $83.86 1,089 9
Troy, MO $20.83 $15.02 – $21.03 1,089 2
Maben, MS $15.20 $11.45 – $18.05 1,091 2
North Randall, OH $7.24 $7.24 – $7.24 1,091 1
Loudonville, NY $15.11 $15.11 – $15.11 1,092 1
Lewisville, TX $6.34 $0.00 – $22.56 1,093 7
Lithia, FL $2.28 $2.28 – $2.28 1,093 1
Holtsville, NY $3.31 $3.31 – $3.31 1,093 1
Elkton, VA $36.73 $16.68 – $37.03 1,094 2
Aldan, PA $23.61 $6.56 – $61.49 1,094 4
Revere, MA $13.10 $1.97 – $30.50 1,096 3
Fort Belvoir, VA $6.29 $5.94 – $18.99 1,096 2
Somers Point, NJ $8.64 $5.51 – $17.19 1,099 2
Old Westbury, NY $14.60 $14.60 – $14.60 1,100 1
Gallup, NM $38.99 $9.64 – $40.12 1,104 3
Anoka, MN $52.73 $52.73 – $52.73 1,104 1
Pinckneyville, IL $5.51 $5.51 – $5.51 1,105 1
King, NC $26.32 $16.75 – $28.00 1,105 2
Seffner, FL $6.68 $6.68 – $6.68 1,105 1
New Castle, PA $17.63 $0.00 – $31.66 1,106 8
Huntingdon, PA $7.45 $2.44 – $22.15 1,109 5
Cabo Rojo, PR $40.96 $3.13 – $58.92 1,112 2
Huntingdon Valley, PA $20.77 $4.53 – $28.92 1,113 4
Kenedy, TX $15.72 $0.00 – $15.96 1,113 2
Copperhill, TN $6.22 $6.22 – $6.22 1,115 1
Ithaca, MI $0.16 $0.16 – $0.16 1,115 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.