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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
Creestwood, KY $2.33 $2.33 – $2.33 1,502 1
Lexington Pk, MD $15.18 $15.18 – $15.18 1,502 1
Purcellville, VA $14.47 $11.88 – $44.23 1,503 2
Lamar, CO $12.07 $10.42 – $65.77 1,506 2
Oyster Bay, NY $14.89 $0.00 – $19.05 1,506 2
Newtown, CT $17.54 $17.44 – $20.10 1,506 2
Peridot, AZ $19.12 $19.12 – $19.12 1,506 1
Amherst, MA $12.01 $10.53 – $16.08 1,507 2
Apex, NC $7.20 $0.00 – $24.02 1,509 4
Hermitage, MO $59.10 $59.10 – $59.10 1,511 1
Bradley, AR $5.16 $5.16 – $5.16 1,514 1
Washinton, DC $54.18 $54.18 – $54.18 1,514 1
Citrus Hills, FL $1.01 $1.01 – $1.01 1,514 1
Westfield, NJ $12.35 $4.04 – $15.13 1,515 3
Crownsville, MD $35.82 $7.87 – $65.02 1,515 2
Centreville, MI $1.57 $1.57 – $1.57 1,516 1
Denton, MD $7.32 $0.00 – $8.70 1,518 2
Watertown, WI $8.59 $0.00 – $18.09 1,519 3
Rienzi, MS $5.66 $5.66 – $5.66 1,519 1
Malden, MA $11.26 $5.04 – $32.93 1,521 4
Chisago City, MN $57.21 $57.21 – $57.21 1,521 1
Canton, NY $3.86 $3.72 – $5.14 1,523 2
Edgewood, NM $51.74 $51.74 – $51.74 1,523 1
Pierre Part, LA $6.15 $6.15 – $6.15 1,523 1
Bells, TN $0.93 $0.93 – $0.93 1,524 1
Shoreline, WA $31.20 $28.02 – $36.93 1,525 3
Gates, NC $18.94 $18.94 – $18.94 1,527 1
Elkton, MD $31.57 $2.10 – $58.55 1,528 7
Clinton Twp, MI $28.83 $8.72 – $44.36 1,528 4
Stayton, OR $26.19 $26.19 – $26.19 1,529 1
Wynne, AR $11.21 $9.03 – $38.44 1,529 3
Park Forest, IL $8.05 $2.26 – $12.00 1,529 2
Johnstown, CO $20.76 $20.41 – $21.01 1,531 2
Temple Hills, MD $25.71 $25.71 – $25.71 1,532 1
Waterford, OH $5.97 $2.87 – $17.31 1,534 4
Newton Lower Falls, MA $0.37 $0.37 – $0.37 1,534 1
Haworth, NJ $4.57 $4.57 – $4.57 1,535 1
Lecompte, LA $0.00 $0.00 – $0.00 1,536 1
Nashville, NC $19.95 $9.51 – $29.37 1,536 3
Lyndhurst, OH $10.72 $10.61 – $20.47 1,539 2
Raymond, NH $0.16 $0.00 – $10.46 1,540 3
Shoreview, MN $8.32 $8.32 – $8.32 1,541 1
Graham, NC $14.81 $12.67 – $15.29 1,543 2
West Linn, OR $13.23 $13.23 – $13.23 1,544 1
Sterlington, LA $0.00 $0.00 – $0.00 1,546 3
Burlington, IA $7.46 $7.46 – $7.46 1,547 1
Helotes, TX $4.80 $4.80 – $4.80 1,547 1
Saint Albans, NY $10.95 $4.38 – $29.02 1,548 3
Ephrata, PA $25.17 $3.21 – $39.46 1,550 7
North Dartmouth, MA $23.41 $10.78 – $38.69 1,550 4

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.