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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
Los Banos, CA $5.60 $0.00 – $42.23 3,380 4
Edmore, MI $46.25 $45.78 – $47.83 3,383 2
Cheektowaga, NY $17.74 $2.09 – $21.76 3,388 4
Jena, LA $2.02 $0.00 – $3.71 3,389 2
Pleasanton, CA $12.53 $1.08 – $34.18 3,390 4
Creedmoor, NC $4.49 $4.49 – $4.49 3,392 1
Branford, CT $12.93 $4.69 – $37.17 3,393 4
Dover, DE $18.75 $0.00 – $49.69 3,394 7
Lebanon, OR $11.69 $0.27 – $35.94 3,396 7
Glendale, WI $27.47 $27.47 – $27.47 3,401 1
Wauseon, OH $11.91 $11.49 – $12.12 3,402 3
Connellsville, PA $20.64 $5.08 – $30.02 3,405 4
Hinton, WV $11.89 $0.00 – $18.00 3,407 5
Placerville, CA $10.23 $0.55 – $12.20 3,408 3
Denver City, TX $33.60 $20.20 – $36.94 3,410 2
Windsor, CT $14.29 $9.21 – $23.87 3,417 4
New Carlisle, OH $15.12 $15.12 – $15.12 3,417 1
Richmond, CA $5.27 $1.83 – $26.79 3,418 5
Woodbury, CT $18.17 $18.17 – $18.17 3,426 1
Plainville, CT $20.73 $2.72 – $41.18 3,428 5
Doylestown, PA $10.51 $2.51 – $29.50 3,429 6
Concord Twp, OH $13.30 $12.70 – $13.30 3,433 2
Lee, MA $13.59 $0.00 – $20.69 3,443 6
Staten Islan, NY $11.77 $11.77 – $11.77 3,443 1
Palo Cedro, CA $5.38 $5.38 – $5.38 3,447 1
Kilmarnock, VA $11.37 $11.33 – $13.27 3,449 2
Pascagoula, MS $14.78 $0.00 – $34.52 3,453 10
Navarre, FL $19.23 $1.32 – $52.86 3,454 2
Dalton, GA $8.43 $1.99 – $19.47 3,455 6
Hastings, NE $21.49 $20.42 – $22.54 3,457 2
Edgewater, MD $27.67 $2.89 – $48.10 3,458 3
Lake Villa, IL $14.36 $3.21 – $16.78 3,460 4
Muncy, PA $9.51 $1.11 – $14.22 3,467 3
Oberlin, OH $10.49 $1.51 – $10.52 3,468 2
Carbondale, IL $16.49 $1.16 – $22.42 3,468 5
Mattapoisett, MA $9.02 $9.02 – $9.02 3,468 1
Manitowoc, WI $19.94 $5.11 – $23.27 3,469 4
Inwood, NY $20.52 $20.52 – $20.52 3,474 1
Monticello, AR $17.63 $10.44 – $19.56 3,476 7
Richfield, MN $22.29 $9.45 – $56.64 3,477 12
Ellenwood, GA $12.61 $12.61 – $12.61 3,480 1
Pasco, WA $39.84 $7.69 – $41.95 3,483 2
Wolfeboro, NH $3.17 $0.00 – $5.81 3,490 5
Laconia, NH $4.94 $1.88 – $12.19 3,490 6
Colusa, CA $41.06 $41.06 – $41.06 3,492 1
Saraland, AL $5.21 $5.13 – $5.89 3,498 2
Cresson, PA $10.51 $0.00 – $14.35 3,501 4
Flossmoor, IL $18.06 $16.18 – $48.54 3,502 3
Lewis Center, OH $14.13 $9.98 – $14.34 3,503 3
Calhoun, GA $18.40 $7.89 – $24.72 3,505 2

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.