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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
Greenville, IL $12.52 $3.17 – $20.98 3,505 3
Great Barrington, MA $18.58 $16.27 – $35.47 3,506 3
Indiana, PA $12.37 $0.00 – $21.33 3,508 9
Moulton, AL $2.45 $2.45 – $2.76 3,509 2
Albany, CA $28.43 $28.43 – $28.43 3,511 1
Carthage, MO $16.13 $13.44 – $39.19 3,512 7
Knoxville, IL $19.32 $19.32 – $19.32 3,516 1
Follansbee, WV $20.15 $20.15 – $20.15 3,520 1
Seward, NE $18.54 $18.54 – $18.54 3,522 1
Canonsburg, PA $20.33 $13.46 – $23.99 3,525 3
Morehead, KY $5.00 $0.60 – $25.34 3,530 10
Shawnee, OK $32.81 $8.26 – $33.85 3,542 4
Adamsville, TN $5.41 $0.00 – $8.16 3,543 3
Storm Lake, IA $8.74 $0.00 – $10.62 3,544 5
Jasper, IN $10.42 $5.00 – $11.49 3,545 7
Englewood, FL $7.76 $7.06 – $11.07 3,546 2
Newberry, SC $29.63 $29.11 – $33.00 3,546 2
Lynchburg, TN $10.24 $10.22 – $10.59 3,547 2
Eustis, FL $4.64 $0.00 – $4.69 3,549 2
Ames, IA $7.79 $2.32 – $8.00 3,550 4
Osawatomie, KS $1.52 $0.96 – $2.28 3,555 4
Alba, TX $6.07 $6.07 – $6.07 3,563 1
Mountain View, CA $6.75 $0.00 – $23.43 3,564 6
Essex, CT $15.61 $11.99 – $25.47 3,566 3
Everett, MA $12.66 $9.17 – $42.34 3,569 5
Euless, TX $5.40 $0.00 – $49.64 3,579 6
Webster, NY $13.58 $0.00 – $36.99 3,581 5
Millersville, MD $15.03 $7.97 – $63.37 3,582 4
Cooperstown, NY $18.96 $3.51 – $51.52 3,585 4
Chantilly, VA $16.99 $0.01 – $42.12 3,588 6
West Sacramento, CA $10.31 $0.00 – $284.50 3,589 4
Bingham Farms, MI $59.06 $0.00 – $62.85 3,591 2
Corry, PA $6.59 $0.00 – $15.16 3,594 4
Hewlett, NY $6.08 $0.03 – $12.68 3,600 4
Cos Cob, CT $13.76 $13.76 – $13.76 3,602 1
Ralston, NE $21.65 $21.65 – $21.65 3,604 1
Orangeburg, SC $24.75 $4.83 – $52.92 3,605 7
Jonesboro, LA $2.09 $0.00 – $4.38 3,609 4
Lake Hopatcong, NJ $11.42 $11.42 – $11.42 3,609 1
Newton, IL $6.08 $6.08 – $6.08 3,615 1
Galax, VA $9.61 $6.83 – $21.47 3,616 3
Somerville, NJ $8.14 $0.49 – $14.90 3,617 6
Dequincy, LA $9.38 $0.00 – $9.45 3,621 2
Somerville, TN $7.04 $0.26 – $10.28 3,621 5
Havertown, PA $7.95 $2.65 – $12.76 3,625 5
Garden City Park, NY $4.95 $4.95 – $4.95 3,626 1
Plymouth, NH $3.68 $3.68 – $3.68 3,627 1
Lowell, AR $19.49 $18.62 – $20.69 3,629 2
Prescott, AR $14.61 $2.13 – $18.41 3,631 3
Topsham, ME $20.12 $20.10 – $21.04 3,639 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.