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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
Caraway, AR $16.77 $16.77 – $16.77 1,779 1
Maple Grove, MN $16.24 $8.94 – $70.28 1,780 4
Odenton, MD $54.38 $18.87 – $56.65 1,780 2
Bedford, MA $7.30 $0.50 – $15.12 1,785 3
Kennesaw, GA $8.46 $8.46 – $8.46 1,789 1
Holly Springs, MS $2.76 $0.00 – $12.58 1,789 3
Norwell, MA $9.69 $5.05 – $22.03 1,789 3
Beacon, NY $6.81 $0.00 – $44.81 1,790 3
Rosenberg, TX $5.35 $0.67 – $6.56 1,790 2
Eldorado, IL $1.80 $0.00 – $3.08 1,791 4
Olive Hill, KY $3.58 $3.58 – $3.58 1,792 1
Eastchester, NY $2.29 $0.09 – $9.97 1,794 3
Cliffwood, NJ $27.95 $27.95 – $27.95 1,794 1
Union, MS $32.63 $32.40 – $42.68 1,796 2
Geneva, IL $23.32 $4.05 – $35.63 1,798 2
Rhinebeck, NY $9.70 $6.93 – $24.31 1,798 3
Fitchburg, WI $10.40 $6.98 – $27.87 1,800 2
Geneva, AL $22.96 $0.07 – $32.56 1,801 3
Pleasant Hill, MO $12.47 $12.47 – $12.47 1,805 1
Ozark, MO $25.55 $25.55 – $25.55 1,808 1
Moorhead, MN $43.46 $23.73 – $65.64 1,809 3
Syracuse, NE $16.54 $16.54 – $16.54 1,809 1
Carrollton, GA $4.55 $4.03 – $5.27 1,810 2
Englewood Cliffs, NJ $5.93 $0.00 – $6.63 1,811 2
St Clair Shores, MI $57.32 $57.32 – $57.32 1,812 1
Jacksonville, IL $20.54 $0.09 – $24.95 1,813 4
Rock Hill, NY $12.46 $11.46 – $13.03 1,815 3
Rochelle, IL $16.48 $3.94 – $23.99 1,815 3
Oak Forest, IL $45.99 $45.99 – $45.99 1,816 1
Seaford, DE $2.27 $0.36 – $30.59 1,818 3
Margate, NJ $19.47 $19.47 – $19.47 1,818 1
Gun Barrel City, TX $5.65 $0.00 – $5.85 1,819 2
Croton On Hudson, NY $0.83 $0.24 – $86.68 1,820 3
Clovis, NM $17.39 $4.25 – $39.00 1,821 5
Warren, AR $15.90 $7.65 – $22.40 1,822 7
Cashmere, WA $34.47 $33.33 – $35.13 1,823 2
Blufield, VA $0.15 $0.15 – $0.15 1,824 1
Caldwell, OH $5.66 $3.33 – $7.35 1,825 3
Phil Campbell, AL $0.00 $0.00 – $0.00 1,825 1
Williamsburg, WV $6.44 $6.44 – $6.44 1,827 1
South Kingstown, RI $5.06 $5.06 – $5.06 1,828 1
East Peoria, IL $31.04 $31.04 – $31.04 1,829 1
Butler, MO $27.08 $11.14 – $28.34 1,832 4
Dewitt, MI $31.53 $31.53 – $31.53 1,832 1
Pittsboro, NC $21.86 $21.51 – $27.45 1,834 2
South Pittsburg, TN $6.03 $6.03 – $6.03 1,835 1
Owens Cross Roads, AL $2.05 $2.05 – $2.05 1,835 1
Franklin Lakes, NJ $29.63 $29.63 – $29.63 1,836 1
Warren, NJ $16.16 $8.67 – $35.33 1,837 3
Terra Alta, WV $10.07 $10.07 – $10.07 1,840 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.