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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
Newport, NH $22.22 $22.22 – $22.22 5,171 1
Amesbury, MA $9.41 $0.59 – $9.87 5,173 3
Estherwood, LA $0.88 $0.88 – $0.88 5,179 1
Jeffersonvlle, IN $8.00 $8.00 – $8.00 5,182 1
Malverne, NY $6.18 $6.18 – $6.18 5,184 1
Rainbow City, AL $3.88 $3.61 – $26.88 5,187 3
Boonville, IN $5.39 $3.15 – $15.16 5,196 3
Idaho Falls, ID $30.32 $9.36 – $46.65 5,209 11
Highland Mills, NY $8.47 $4.56 – $8.52 5,210 2
Lugoff, SC $6.66 $2.11 – $12.00 5,214 3
Cedar Grove, NJ $5.31 $0.00 – $7.70 5,217 5
Bonne Terre, MO $15.02 $12.63 – $74.74 5,218 4
Red Bank, NJ $6.78 $2.30 – $19.72 5,221 11
Marshfield, WI $16.77 $2.49 – $36.47 5,231 11
Burkesville, KY $19.34 $0.00 – $42.91 5,237 4
Independence, KY $6.59 $6.59 – $6.59 5,237 1
Robbinsville, NC $18.88 $12.99 – $19.64 5,238 2
Aurora, MO $23.84 $23.84 – $23.84 5,240 1
Austintown, OH $9.67 $1.82 – $19.75 5,249 11
Crooksville, OH $11.78 $1.22 – $12.13 5,260 2
Benton, IL $1.06 $0.02 – $20.38 5,261 3
Pataskala, OH $22.65 $4.51 – $23.32 5,263 4
Cedar Hill, MO $23.51 $13.55 – $24.16 5,268 5
Barnesville, OH $1.73 $0.02 – $9.16 5,273 5
West New York, NJ $5.90 $5.15 – $6.36 5,284 4
Princeton, IN $12.30 $0.00 – $15.48 5,288 4
Centralia, WA $10.89 $5.10 – $11.25 5,288 3
Laurelton, NY $11.61 $11.61 – $11.61 5,297 1
Jefferson Hills, PA $16.80 $10.48 – $38.99 5,300 7
South Point, OH $6.95 $6.95 – $6.95 5,323 1
Fuquay Varina, NC $13.91 $4.02 – $15.66 5,327 3
Portland, CT $11.54 $11.54 – $11.54 5,348 1
Romeoville, IL $19.14 $5.12 – $43.71 5,354 3
Monroe, MI $11.60 $1.16 – $57.69 5,355 9
Kemp, TX $7.98 $7.98 – $7.98 5,358 1
Willingboro, NJ $17.51 $10.85 – $26.97 5,360 2
Newport, KY $9.49 $7.71 – $12.02 5,365 3
Newburyport, MA $12.47 $1.21 – $16.33 5,370 8
Carencro, LA $3.08 $3.08 – $3.08 5,372 1
Provo, UT $51.12 $5.29 – $76.24 5,373 8
Plymouth, MI $14.59 $13.45 – $26.46 5,374 2
Macon, GA $10.23 $3.78 – $54.67 5,375 10
Clinton, IL $0.03 $0.00 – $2.22 5,381 2
Sandrock, AL $0.00 $0.00 – $0.00 5,382 1
Seymour, WI $22.73 $10.65 – $24.36 5,388 2
Erwin, NC $9.81 $1.35 – $20.41 5,394 4
Highland Springs, VA $5.95 $5.95 – $5.95 5,395 1
Watsontown, PA $9.84 $9.84 – $9.84 5,396 1
Mexia, TX $13.91 $1.80 – $25.81 5,401 4
Bulverde, TX $5.71 $5.71 – $5.71 5,404 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.