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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
Greenacres, FL $14.59 $1.33 – $51.11 2,758 6
Brodhead, KY $6.13 $6.13 – $6.13 2,764 1
Cedar City, UT $15.34 $6.01 – $34.47 2,766 5
Indian Land, SC $19.37 $13.46 – $20.31 2,767 5
Blacksburg, VA $7.63 $7.20 – $34.19 2,768 3
Oceanside, CA $24.81 $9.34 – $41.21 2,769 9
Ripley, TN $5.77 $4.55 – $6.95 2,771 3
Bristol, RI $16.12 $5.76 – $19.57 2,773 4
South Gate, CA $4.89 $0.00 – $25.55 2,779 3
Mangonia Park, FL $3.63 $3.63 – $3.63 2,780 1
Seneca Falls, NY $7.21 $0.00 – $7.58 2,781 4
Brockway, PA $22.09 $10.53 – $33.82 2,781 3
New Hope, PA $14.74 $14.74 – $14.74 2,781 1
Perry, OH $5.70 $5.70 – $5.70 2,783 1
Elkhorn, WI $15.30 $12.75 – $27.52 2,787 4
Wakefield, MA $4.75 $4.75 – $4.75 2,788 1
Mercerville, NJ $31.97 $30.39 – $34.80 2,794 3
Valdosta, GA $7.63 $3.79 – $16.30 2,797 3
Pierre, SD $25.95 $25.95 – $25.95 2,798 1
North Baldwin, NY $2.50 $2.50 – $2.50 2,800 1
Woodbury, MN $38.10 $9.39 – $68.42 2,809 6
Eddyville, KY $9.20 $7.16 – $28.91 2,810 3
Campbell, OH $9.95 $9.94 – $11.51 2,810 2
Olean, NY $4.64 $0.00 – $4.68 2,813 3
Claremont, NH $6.39 $6.39 – $6.39 2,813 1
Lapeer, MI $17.88 $10.74 – $37.93 2,816 4
Wetumpka, AL $4.08 $4.08 – $4.08 2,819 1
Scott, AR $9.44 $9.44 – $9.44 2,820 1
Rome, GA $12.89 $12.37 – $17.74 2,827 2
Waxahachie, TX $4.34 $0.00 – $7.26 2,827 8
Livingston, TX $3.27 $0.00 – $3.39 2,830 2
Medway, MA $16.92 $12.44 – $19.44 2,830 3
Johnson City, NY $13.46 $1.67 – $26.39 2,834 10
Wantagh, NY $5.72 $5.66 – $9.04 2,834 2
Blue Bell, PA $11.28 $6.62 – $18.98 2,838 5
Candler, NC $18.26 $17.39 – $32.36 2,838 3
Ashland, AL $6.72 $5.39 – $18.43 2,839 2
Sweetwater, TN $9.70 $6.95 – $11.16 2,841 4
Paola, KS $1.24 $1.24 – $1.24 2,843 1
Turners Falls, MA $11.70 $7.97 – $11.99 2,845 3
Kentwood, LA $54.89 $1.61 – $75.21 2,847 2
Putney, VT $10.11 $10.11 – $10.11 2,848 1
Mayo, FL $5.18 $5.18 – $5.18 2,850 1
Big Spring, TX $8.97 $6.66 – $9.36 2,856 3
Park City, UT $18.71 $18.71 – $18.71 2,862 1
Memphis, MO $26.93 $19.75 – $27.06 2,862 3
Drexel Hill, PA $18.99 $0.00 – $23.39 2,865 5
Cassopolis, MI $0.02 $0.02 – $0.02 2,870 1
Signal Hill, CA $15.78 $15.78 – $15.78 2,876 1
Sharon, MA $16.97 $8.59 – $25.19 2,878 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.