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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
Aberdeen, WA $8.26 $6.00 – $20.03 2,880 3
Woodworth, LA $0.00 $0.00 – $0.00 2,883 1
Healdsburg, CA $11.80 $5.82 – $49.85 2,883 3
Ashtabula, OH $11.57 $4.12 – $20.44 2,884 6
Belmont, MA $11.34 $9.61 – $15.58 2,885 3
Prince George, VA $10.03 $6.85 – $15.33 2,885 2
N Olmstead, OH $10.48 $10.48 – $10.48 2,886 1
Ft Wright, KY $42.38 $9.00 – $53.81 2,890 2
Clarksburg, MD $31.78 $31.78 – $31.78 2,894 1
Mc Leansville, NC $16.10 $12.26 – $16.70 2,897 2
Galena, KS $8.24 $1.44 – $8.33 2,905 2
Broken Bow, OK $19.42 $19.42 – $19.42 2,908 1
Barre, MA $17.30 $16.40 – $17.31 2,910 2
Platte City, MO $20.75 $8.42 – $26.35 2,910 5
Freeport, IL $10.29 $0.00 – $29.82 2,912 7
Oshkosh, WI $28.97 $6.26 – $54.65 2,915 13
Arvada, CO $13.55 $4.33 – $28.97 2,915 12
Fort Madison, IA $6.54 $5.48 – $22.43 2,915 5
Woodward, OK $25.70 $6.70 – $29.21 2,916 3
Highland Beach, FL $6.84 $6.84 – $6.84 2,923 1
Tishomingo, OK $32.58 $6.08 – $37.26 2,923 3
Berlin, VT $13.44 $1.68 – $17.21 2,925 9
Jay, FL $6.87 $4.54 – $10.13 2,927 3
Great Falls, VA $10.81 $10.81 – $10.81 2,930 1
Batavia, IL $10.49 $3.33 – $21.45 2,936 6
Cedartown, GA $3.54 $3.54 – $3.54 2,938 1
Shallotte, NC $11.68 $0.88 – $17.21 2,939 4
Pomona, NJ $5.13 $4.39 – $16.33 2,940 5
Brookland, AR $10.97 $8.39 – $15.11 2,943 2
Tomball, TX $7.85 $1.69 – $17.48 2,945 6
Robeline, LA $8.95 $8.95 – $8.95 2,946 1
Wayne, PA $24.54 $1.47 – $32.41 2,950 7
Walsenburg, CO $14.56 $12.36 – $113.08 2,952 4
Richland, MI $18.31 $18.31 – $18.31 2,952 1
Hermiston, OR $15.43 $10.54 – $24.49 2,953 3
Kent, WA $29.29 $2.98 – $50.49 2,955 8
Lorton, VA $4.54 $4.31 – $15.69 2,956 2
Kirkland, WA $32.04 $2.82 – $51.64 2,960 8
Lenoir, NC $11.45 $4.96 – $42.69 2,961 9
Carbondale, PA $7.31 $1.79 – $14.47 2,962 5
Hackleburg, AL $0.05 $0.05 – $0.05 2,962 1
Wrightsville, GA $47.14 $0.17 – $49.84 2,963 2
Canton, IL $17.64 $0.00 – $18.39 2,964 3
Mount Carmel, PA $19.14 $10.61 – $29.43 2,965 2
Newtown Square, PA $12.12 $9.03 – $12.47 2,965 2
Windsor Mill, MD $56.08 $6.29 – $73.11 2,965 5
Batesville, IN $7.24 $0.00 – $65.42 2,971 6
Dierks, AR $13.70 $13.70 – $13.70 2,975 1
Foley, AL $2.57 $1.03 – $3.38 2,979 3
Cohasset, MA $5.63 $5.63 – $5.63 2,987 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.