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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
Hartford City, IN $10.93 $5.70 – $11.94 5,404 2
Lavonia, GA $3.09 $3.09 – $3.09 5,405 1
Campton, KY $3.63 $3.36 – $6.45 5,410 4
La Grange Park, IL $7.99 $7.98 – $8.60 5,410 2
Hyde Park, MA $13.91 $6.14 – $24.61 5,417 3
Booneville, MS $19.01 $4.20 – $137.68 5,427 12
Destin, FL $7.52 $0.00 – $7.54 5,432 2
Garwood, NJ $15.55 $15.55 – $15.55 5,434 1
Little River, SC $15.32 $4.58 – $16.81 5,441 2
Latham, NY $5.77 $0.03 – $15.28 5,443 7
Indio, CA $21.12 $9.63 – $31.97 5,452 4
Yorktown Heights, NY $8.25 $0.00 – $9.84 5,454 4
Mccordsville, IN $14.15 $14.15 – $14.15 5,454 1
South Carolina, SC $15.91 $15.91 – $15.91 5,455 1
Madison, CT $4.45 $0.00 – $7.17 5,460 4
Saco, ME $22.59 $15.91 – $26.93 5,461 14
Plainsboro, NJ $12.69 $0.00 – $18.15 5,471 5
Havre De Grace, MD $17.99 $15.00 – $49.71 5,472 4
Fayetteville, AR $15.60 $0.00 – $19.19 5,493 11
Randleman, NC $14.64 $14.64 – $14.64 5,496 1
Summit, WI $23.43 $21.21 – $25.24 5,500 2
Forsyth, IL $19.53 $19.53 – $19.53 5,504 1
Lodi, NJ $12.94 $0.00 – $13.70 5,505 4
Morton, MS $28.74 $16.72 – $30.45 5,508 5
Decatur, IN $12.37 $7.47 – $33.83 5,511 7
North Bend, OH $19.87 $19.87 – $19.87 5,513 1
Caldwell, ID $19.75 $10.22 – $38.32 5,517 4
West Memphis, AR $15.85 $0.00 – $25.65 5,523 10
Alamogordo, NM $22.88 $4.73 – $39.33 5,531 5
Kingston Springs, TN $11.67 $11.67 – $11.67 5,535 1
Elko, NV $13.24 $0.00 – $24.72 5,536 5
East Providence, RI $18.57 $0.19 – $23.66 5,543 7
Climax, NC $8.42 $8.42 – $8.42 5,551 1
Muskego, WI $24.20 $24.20 – $24.20 5,557 1
Savannah, GA $16.05 $2.01 – $114.34 5,562 12
Sedalia, MO $19.58 $3.90 – $47.36 5,562 8
Port Angeles, WA $12.26 $0.55 – $22.16 5,566 7
North Port, FL $0.89 $0.88 – $2.24 5,567 2
College Station, TX $10.88 $2.55 – $62.78 5,578 8
Del Rio, TX $2.20 $0.00 – $8.08 5,579 5
Bellaire, TX $4.09 $2.59 – $6.20 5,589 4
Aiken, SC $17.38 $0.00 – $27.76 5,590 10
Clanton, AL $9.73 $1.49 – $19.45 5,591 2
Westminster, CO $13.46 $2.42 – $33.87 5,594 9
Wallingford, PA $17.78 $17.78 – $17.78 5,597 1
Port Richey, FL $3.82 $0.00 – $39.04 5,614 7
Buckeye, AZ $37.11 $37.11 – $37.11 5,623 1
Batesville, AR $14.96 $8.79 – $21.13 5,623 9
Parrottsville, TN $8.74 $8.74 – $8.74 5,629 1
Garrett, IN $11.29 $9.24 – $11.35 5,633 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.