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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
Vacherie, LA $0.00 $0.00 – $0.00 2,565 1
Lafayette, CO $7.48 $0.00 – $42.60 2,572 6
Cheshire, CT $9.29 $0.00 – $18.92 2,572 7
Susanville, CA $40.12 $0.00 – $335.14 2,572 4
Gilmer, TX $4.87 $3.49 – $10.14 2,580 3
Nowata, OK $28.87 $28.87 – $28.87 2,582 1
Churchton, MD $40.64 $11.97 – $48.22 2,587 2
Keokuk, IA $6.19 $0.00 – $6.77 2,590 3
Harrington Park, NJ $9.56 $3.42 – $10.16 2,592 5
White Plains, MD $50.04 $45.03 – $64.96 2,594 3
Bethel, CT $14.91 $14.91 – $14.91 2,595 1
Hudson, MA $9.04 $8.39 – $23.96 2,597 3
Evans, GA $25.17 $9.01 – $35.33 2,598 5
Fort Payne, AL $0.37 $0.27 – $0.66 2,599 3
Somersworth, NH $8.80 $8.80 – $8.80 2,602 1
Wood Ridge, NJ $11.34 $11.34 – $11.34 2,602 1
Claremont, CA $11.30 $0.00 – $20.08 2,605 4
Sheridan, WY $14.31 $4.92 – $31.28 2,606 6
Malibu, CA $29.17 $29.17 – $29.17 2,608 1
Demorest, GA $19.56 $19.56 – $19.56 2,609 1
Barnhart, MO $17.61 $17.61 – $17.61 2,609 1
Stephens City, VA $13.32 $11.34 – $14.58 2,610 2
Cuthbert, GA $4.68 $0.00 – $37.13 2,615 3
Gallipolis, OH $6.78 $0.00 – $10.21 2,616 7
Norfolk, NE $16.23 $0.00 – $34.40 2,616 7
Brunswick, MO $31.93 $31.93 – $31.93 2,618 1
Dansville, NY $16.13 $8.08 – $17.02 2,622 2
Burnsville, NC $10.04 $10.04 – $10.04 2,627 1
Windcrest, TX $6.00 $6.00 – $6.00 2,630 1
Scottsville, KY $32.24 $18.60 – $32.56 2,635 3
Walnut Grove, MS $13.75 $11.55 – $13.99 2,636 2
Denville, NJ $9.31 $0.39 – $25.89 2,640 5
Ramsey, NJ $7.16 $4.74 – $19.58 2,643 3
Belfast, ME $9.74 $8.72 – $43.32 2,647 2
Heber Springs, AR $14.28 $13.82 – $14.75 2,647 2
Billerica, MA $66.80 $66.80 – $66.80 2,648 1
Seneca, SC $9.99 $2.91 – $19.29 2,650 6
Leitchfield, KY $4.13 $1.65 – $7.14 2,654 5
Moira, NY $7.63 $7.63 – $7.63 2,654 1
Royersford, PA $10.92 $8.26 – $21.91 2,657 3
Signal Mountain, TN $8.45 $6.28 – $14.04 2,660 4
South Boston, VA $11.42 $7.91 – $40.67 2,662 3
Montrose, CA $21.36 $17.73 – $40.02 2,663 3
Eureka, MO $15.50 $15.50 – $15.50 2,664 1
Humble, TX $3.84 $1.25 – $18.02 2,671 8
Shelburn, IN $7.17 $6.82 – $9.40 2,672 2
Fleming Island, FL $5.18 $5.12 – $8.11 2,673 2
Liverpool, PA $10.89 $10.89 – $10.89 2,674 1
Valley Falls, KS $23.20 $4.82 – $26.41 2,674 2
Forest, MS $14.77 $5.07 – $27.90 2,677 6

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.