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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
Norwalk, OH $9.66 $1.63 – $18.73 1,551 6
Oneonta, NY $4.89 $0.00 – $12.61 1,556 6
Neenah, WI $6.45 $6.17 – $9.87 1,559 2
Bude, MS $15.12 $15.12 – $15.12 1,560 1
Bassfield, MS $0.00 $0.00 – $0.00 1,560 1
Savanna, IL $10.82 $10.82 – $10.82 1,561 1
South Burlington, VT $0.74 $0.00 – $19.07 1,565 5
Port Chester, NY $8.55 $0.80 – $9.33 1,565 2
Camden, OH $9.43 $9.36 – $14.61 1,565 2
North Easton, MA $14.36 $11.12 – $18.23 1,567 2
Wawarsing, NY $1.92 $1.92 – $1.92 1,567 1
Hiawatha, IA $0.21 $0.21 – $0.21 1,568 1
Gloucester, VA $9.51 $9.43 – $9.62 1,570 2
Newmarket, NH $2.75 $0.00 – $2.91 1,570 3
Black Jack, MO $15.01 $15.01 – $15.01 1,570 1
Truth Or Consequences, NM $33.66 $11.44 – $50.32 1,571 4
Conyers, GA $12.52 $9.77 – $14.29 1,572 4
Avilla, IN $5.33 $4.99 – $8.24 1,572 2
Glen Gardner, NJ $11.15 $11.15 – $11.15 1,573 1
Marshfield, MO $19.55 $19.27 – $22.17 1,574 2
Marysville, CA $7.43 $0.00 – $37.42 1,579 5
Willits, CA $130.41 $0.00 – $318.11 1,579 3
Onawa, IA $3.79 $0.20 – $39.50 1,581 4
Monticello, NY $2.48 $2.23 – $5.44 1,582 2
Winthrop, MA $6.70 $6.70 – $6.70 1,584 1
Evansdale, IA $13.56 $13.56 – $13.56 1,585 1
Altamont, IL $10.30 $10.30 – $10.30 1,587 1
Brush Prairie, WA $14.09 $14.09 – $14.09 1,588 1
Stockbridge, GA $12.59 $12.59 – $12.59 1,591 1
Lewistown, PA $17.19 $15.18 – $48.46 1,595 3
Dushore, PA $15.95 $15.95 – $15.95 1,595 1
Myton, UT $37.00 $37.00 – $37.00 1,600 1
Westwood, NJ $11.34 $0.00 – $11.77 1,601 3
Diamondhead, MS $10.95 $0.00 – $16.72 1,601 4
Conrad, IA $21.65 $0.00 – $29.82 1,602 3
Jolie, IL $25.83 $25.83 – $25.83 1,602 1
Plno, TX $4.63 $4.63 – $4.63 1,602 1
Falmouth, KY $9.90 $9.90 – $9.90 1,603 1
Woodland, AL $2.52 $2.52 – $2.52 1,603 1
Satsuma, AL $0.00 $0.00 – $0.00 1,607 1
Fern Park, FL $6.18 $6.18 – $6.18 1,608 1
Amelia, VA $5.19 $5.19 – $5.19 1,609 1
Edna, TX $28.42 $24.19 – $28.73 1,610 2
Titusville, PA $16.72 $16.24 – $17.22 1,614 2
Old Forge, PA $2.59 $0.00 – $2.70 1,616 2
Seymour, TX $17.47 $17.47 – $17.47 1,618 1
Price, UT $10.50 $5.65 – $22.71 1,621 3
Maiden Rock, WI $37.34 $37.34 – $37.34 1,621 1
Centerville, TN $24.30 $21.52 – $25.79 1,622 2
Zionsville, IN $10.11 $4.33 – $28.94 1,625 3

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.