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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
Hallettsville, TX $27.02 $0.00 – $27.57 1,988 3
Mount Vernon, OH $19.81 $8.37 – $21.91 1,989 4
Hebron, OH $10.77 $10.77 – $10.77 1,990 1
La Plata, MD $52.11 $52.11 – $52.11 1,992 1
Youngsville, LA $5.24 $5.24 – $5.24 1,993 1
Elizabeth, WV $5.47 $5.47 – $5.47 1,994 1
Tappahannock, VA $10.27 $10.10 – $13.53 1,998 2
Santa Rosa Beach, FL $6.89 $6.89 – $6.89 1,999 1
Hutchinson, KS $17.25 $2.11 – $25.26 2,001 5
Bucyrus, OH $12.35 $6.36 – $25.23 2,001 6
Easton, MD $24.97 $9.78 – $78.30 2,005 5
Feasterville Trevose, PA $17.15 $17.15 – $17.15 2,007 1
Sugarloaf, PA $15.86 $8.40 – $19.01 2,009 3
Glendale Heights, IL $12.20 $1.00 – $30.31 2,009 3
Hartsdale, NY $13.79 $0.00 – $14.00 2,010 3
Southlake, TX $16.24 $15.77 – $25.61 2,012 2
Angleton, TX $7.03 $0.01 – $16.87 2,013 4
Monroe Township, NJ $0.69 $0.69 – $0.69 2,015 1
Livermore, CA $24.65 $2.75 – $40.60 2,017 5
Long Branch, NJ $11.54 $3.14 – $17.15 2,023 6
Ashland, NE $20.98 $20.98 – $20.98 2,024 1
Ballinger, TX $3.29 $3.29 – $3.29 2,026 1
Duncanville, TX $18.51 $5.77 – $35.42 2,027 2
Yardley, PA $11.36 $2.84 – $16.11 2,028 4
Grayling, MI $0.23 $0.23 – $0.23 2,029 1
Charleston, MO $33.01 $32.99 – $35.15 2,032 3
Coos Bay, OR $17.07 $0.15 – $25.75 2,033 4
Greensburg, IN $20.61 $1.15 – $23.17 2,036 5
Fairview Heights, IL $27.19 $2.01 – $28.79 2,038 3
Bartow, FL $1.76 $1.76 – $1.76 2,040 1
Springfield, MN $35.36 $32.94 – $36.74 2,040 2
Cuero, TX $9.20 $0.00 – $12.82 2,042 3
Jeannette, PA $12.61 $8.36 – $14.09 2,046 2
Montrose, CO $19.76 $6.07 – $37.99 2,047 5
Kaufman, TX $4.15 $4.15 – $4.15 2,047 1
Clio, SC $21.19 $21.19 – $21.19 2,052 1
Rayland, OH $6.78 $6.77 – $7.46 2,054 2
Camden, AL $4.72 $0.00 – $4.78 2,057 2
Acworth, GA $4.34 $4.34 – $4.34 2,058 1
Hohenwald, TN $14.32 $2.88 – $15.75 2,058 2
St Cloud, MN $56.23 $53.69 – $75.08 2,060 3
Fairbanks, AK $18.37 $17.75 – $98.50 2,061 2
Lowell, IN $6.67 $1.97 – $6.80 2,062 2
Mount Ayr, IA $16.51 $5.71 – $23.88 2,063 6
Brookpark, OH $19.61 $19.61 – $19.61 2,064 1
New Carlisle, IN $6.89 $4.04 – $13.24 2,067 2
Alvin, TX $12.38 $2.05 – $20.56 2,068 4
Orem, UT $8.70 $0.00 – $37.52 2,069 5
Woodinville, WA $21.88 $10.04 – $29.37 2,069 3
Frankfort, IN $9.88 $9.88 – $9.88 2,070 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.