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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
Rochester, MI $56.40 $49.68 – $57.74 1,629 2
Ventnor City, NJ $1.01 $1.01 – $1.01 1,631 1
Park Hill, OK $8.48 $8.48 – $8.48 1,631 1
Moss Point, MS $6.00 $4.32 – $13.29 1,632 2
Liverpool, NY $13.59 $0.00 – $34.41 1,633 6
Churchville, NY $9.17 $9.17 – $9.17 1,633 1
Mount Vernon, TX $0.12 $0.12 – $0.12 1,635 1
Streator, IL $8.04 $4.20 – $9.65 1,635 4
Wilkes-Barre, PA $13.12 $13.12 – $13.12 1,636 1
Milford, NH $5.37 $5.37 – $5.37 1,636 1
York, SC $7.01 $3.71 – $20.12 1,636 4
Morristown, NY $12.68 $12.68 – $12.68 1,637 1
Dermott, AR $14.99 $14.99 – $14.99 1,638 1
Peculiar, MO $6.75 $6.75 – $6.75 1,640 1
Glendive, MT $0.03 $0.00 – $3.58 1,643 2
Riverton, IL $12.01 $12.01 – $12.01 1,643 1
Berlin, MD $5.11 $0.00 – $58.18 1,644 6
Corning, NY $7.91 $6.15 – $15.42 1,645 3
Wisconsin Dells, WI $18.13 $18.13 – $18.13 1,648 1
Piedmont, CA $22.05 $22.05 – $22.05 1,651 1
Fountain Run, KY $4.77 $4.77 – $4.77 1,651 1
Florence, OR $37.47 $20.05 – $40.16 1,652 3
Whitehall, PA $5.86 $5.17 – $14.72 1,653 3
North Falmouth, MA $12.02 $12.02 – $12.02 1,655 1
North Bay Village, FL $2.52 $0.00 – $4.12 1,656 3
Villa Park, IL $1.20 $1.20 – $1.20 1,658 1
Port Townsend, WA $6.33 $0.00 – $6.40 1,659 2
Martin, SD $32.28 $32.28 – $32.28 1,659 1
Garysburg, NC $7.89 $7.89 – $7.89 1,663 1
Fairmont, MN $66.74 $10.35 – $135.50 1,664 3
Saint Marys, OH $10.71 $10.71 – $10.71 1,664 1
Apalachicola, FL $5.82 $5.82 – $5.82 1,664 1
Summerfield, NC $6.59 $6.59 – $6.59 1,672 1
Middletown, DE $7.56 $0.00 – $31.57 1,677 6
Burleson, TX $8.23 $3.80 – $54.02 1,679 5
Shaker Hts, OH $9.93 $6.51 – $10.37 1,681 2
Edgewood, MD $58.40 $13.74 – $60.55 1,681 2
Shermans Dale, PA $15.19 $12.16 – $17.69 1,683 2
Mequon, WI $16.80 $0.00 – $29.23 1,686 6
Woodstock, NY $6.75 $6.75 – $6.75 1,689 1
St Johnsbury, VT $15.63 $14.23 – $18.76 1,691 3
Colebrook, NH $12.05 $5.40 – $24.57 1,691 3
Woodmere, OH $25.27 $9.52 – $25.51 1,695 2
Houston, MO $17.99 $7.58 – $20.84 1,696 2
Port Orchard, WA $13.98 $8.38 – $14.28 1,697 3
Anacortes, WA $29.10 $29.10 – $29.10 1,700 1
Dunkirk, NY $36.89 $0.00 – $43.98 1,700 3
Belzoni, MS $15.90 $14.66 – $34.63 1,700 4
Groton, CT $10.57 $3.05 – $17.65 1,701 4
Scituate, MA $11.02 $11.02 – $11.02 1,702 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.