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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
Leander, TX $5.24 $0.91 – $5.44 2,375 2
Steele, MO $33.79 $33.79 – $33.79 2,377 1
Poland, OH $8.99 $8.22 – $22.24 2,385 5
North Venice, FL $5.49 $5.49 – $5.49 2,388 1
Broadview Heights, OH $15.66 $5.13 – $16.06 2,389 2
Hancock, NY $6.66 $6.66 – $6.66 2,389 1
Saint Michael, MN $16.23 $16.23 – $16.23 2,390 1
Yorkville, IL $7.31 $5.32 – $9.46 2,394 2
Valdese, NC $6.09 $6.09 – $6.09 2,396 1
Spearfish, SD $23.18 $23.18 – $23.18 2,397 1
Abington, PA $9.69 $0.00 – $54.77 2,399 7
Springfield, KY $22.15 $5.64 – $35.92 2,401 3
Princeton, MA $9.37 $9.37 – $9.37 2,404 1
Butler, PA $16.34 $10.99 – $18.79 2,405 4
Kannapolis, NC $19.29 $16.66 – $22.75 2,406 2
Monahans, TX $16.25 $12.08 – $20.45 2,406 2
Weiser, ID $15.83 $15.83 – $15.83 2,408 1
Fulshear, TX $8.40 $0.94 – $8.55 2,410 2
Duncansville, PA $2.68 $2.68 – $2.68 2,410 1
Mangilao, GU $3.35 $3.35 – $3.35 2,412 1
Concord, AR $17.72 $17.72 – $17.72 2,414 1
Othello, WA $8.65 $0.00 – $8.80 2,419 2
Lawrence, KS $5.31 $0.00 – $8.34 2,422 10
District Heights, MD $30.53 $30.53 – $30.53 2,435 1
Andrews, TX $22.74 $22.74 – $22.74 2,443 1
North East, MD $50.81 $50.81 – $50.81 2,443 1
Humboldt, TN $6.69 $4.98 – $9.08 2,446 3
Barlow, KY $4.70 $2.32 – $68.52 2,448 2
Ithaca, NY $7.73 $0.00 – $9.64 2,450 6
Bethany, CT $13.38 $13.38 – $13.38 2,452 1
Stigler, OK $12.11 $6.12 – $20.18 2,453 3
Belton, TX $6.10 $6.10 – $6.10 2,456 1
Pennsauken, NJ $11.33 $2.13 – $15.16 2,456 3
Wood River, IL $1.81 $1.81 – $1.81 2,457 1
West Reading, PA $27.13 $14.40 – $44.71 2,461 4
Perry, IA $14.44 $0.00 – $20.37 2,461 5
Bonney Lake, WA $16.92 $14.80 – $47.19 2,466 3
Linton, IN $8.11 $5.20 – $14.52 2,467 3
Mount Airy, MD $46.92 $46.92 – $46.92 2,468 1
Newtown, PA $12.28 $4.38 – $17.51 2,468 10
Itasca, IL $11.77 $11.77 – $11.77 2,468 1
Nanticoke, PA $9.57 $7.75 – $9.96 2,469 3
Gulf Breeze, FL $2.84 $0.00 – $5.41 2,474 6
Wailuku, HI $24.18 $14.27 – $31.42 2,475 3
Hampstead, NC $30.83 $25.22 – $56.14 2,477 4
Williston, VT $13.11 $8.29 – $19.65 2,478 9
Racine, WI $17.77 $7.10 – $22.04 2,479 6
Elkhorn City, KY $0.59 $0.59 – $0.59 2,479 1
West Pittston, PA $11.52 $6.36 – $20.59 2,480 6
Neptune Beach, FL $24.87 $0.00 – $26.74 2,481 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.