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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
London, OH $12.30 $12.30 – $12.30 1,271 1
Potosi, MO $32.36 $10.24 – $54.98 1,272 5
Mc Kees Rocks, PA $13.25 $4.22 – $56.89 1,273 3
Bristow, OK $17.06 $17.06 – $17.06 1,273 1
Hardwick, VT $14.01 $14.01 – $14.01 1,275 1
Hickory, MS $11.42 $11.42 – $11.42 1,276 1
Weatherford, OK $26.54 $9.52 – $32.23 1,277 3
Newington, NH $4.55 $4.55 – $4.55 1,277 1
Gilman, CT $12.56 $12.56 – $12.56 1,277 1
Hartford, KY $5.92 $4.35 – $7.24 1,278 3
Florence, CO $30.31 $28.13 – $31.71 1,279 2
Mount Clemens, MI $8.51 $7.61 – $47.25 1,280 2
Smithville, TX $8.90 $8.90 – $8.90 1,281 1
Courtland, VA $9.32 $9.05 – $10.61 1,282 2
Lantana, TX $28.65 $28.65 – $28.65 1,282 1
La Junta, CO $25.40 $25.40 – $25.40 1,283 1
Bellmore, NY $24.39 $24.39 – $24.39 1,285 1
Cambridge, OH $10.77 $0.00 – $11.87 1,286 3
Dalton, OH $19.93 $18.46 – $19.99 1,290 2
Prosper, TX $4.35 $0.57 – $7.95 1,291 3
Oakland, MS $18.79 $18.79 – $18.79 1,291 1
Brenham, TX $14.27 $1.01 – $21.67 1,292 4
Sioux City, IA $12.52 $2.00 – $21.99 1,292 10
Mather, CA $6.19 $6.06 – $8.27 1,293 2
Chico, CA $52.96 $0.00 – $257.25 1,295 13
West Point, MS $17.22 $16.88 – $21.41 1,295 2
Midlothian, IL $17.36 $17.36 – $17.36 1,295 1
Kalida, OH $3.73 $0.00 – $5.16 1,296 4
Fairfax, VT $3.84 $3.84 – $3.84 1,297 1
Aberdeen, MD $45.23 $44.92 – $60.96 1,298 2
West Boylston, MA $4.80 $4.80 – $4.80 1,298 1
Mars Hill, ME $11.72 $11.72 – $11.72 1,298 1
Mc Lean, VA $20.57 $0.00 – $26.30 1,299 4
Superior, WI $30.74 $0.00 – $72.12 1,300 6
Effingham, SC $8.12 $4.91 – $10.55 1,300 2
Elba, AL $4.89 $4.89 – $4.89 1,301 1
Middleton, WI $6.97 $4.61 – $21.59 1,302 3
Sarepta, LA $0.74 $0.74 – $0.74 1,304 1
Saint George, SC $19.14 $16.65 – $27.81 1,304 2
Oskaloosa, KS $10.27 $9.72 – $11.34 1,306 2
Beaver Dam, WI $16.07 $7.19 – $30.35 1,306 4
Hampton Bays, NY $9.85 $7.30 – $33.05 1,308 3
Sea Girt, NJ $12.22 $1.06 – $13.45 1,308 4
North Kansas City, MO $18.83 $6.21 – $49.82 1,309 10
Brookline, MA $11.31 $0.00 – $21.24 1,311 6
Seneca, PA $10.94 $7.41 – $17.41 1,311 3
Patterson, NY $8.58 $8.58 – $8.58 1,311 1
Sayre, OK $14.09 $10.42 – $14.65 1,312 2
Kennebunk, ME $20.34 $2.94 – $23.87 1,313 2
Mountain Grove, MO $20.10 $17.44 – $88.54 1,314 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.