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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
Martins Ferry, OH $5.65 $3.79 – $15.23 5,853 4
Skowhegan, ME $20.26 $18.61 – $22.75 5,855 3
Colonial Heights, VA $9.05 $2.56 – $16.01 5,857 6
Pelham, AL $10.18 $2.00 – $18.30 5,862 3
Dearborn Heights, MI $44.21 $43.58 – $61.94 5,862 3
Erin, TN $8.69 $7.33 – $9.02 5,862 4
Fort Sam Houston, TX $8.25 $6.17 – $30.78 5,865 3
Midland, TX $6.21 $0.91 – $10.71 5,868 4
Boonville, MO $24.73 $16.13 – $39.75 5,868 2
West Hills, CA $21.43 $0.00 – $37.01 5,870 10
Monroe Twp, NJ $7.82 $1.18 – $15.33 5,872 3
Maynardville, TN $11.97 $0.03 – $19.90 5,873 3
Sharon, PA $19.15 $5.85 – $26.88 5,880 3
East Windsor, NJ $7.42 $2.06 – $7.52 5,881 3
Pompano Beach, FL $5.09 $0.89 – $42.89 5,882 8
Des Peres, MO $8.26 $8.26 – $8.26 5,882 1
New Berlin, WI $11.88 $11.72 – $29.30 5,883 2
Tolleson, AZ $36.65 $36.65 – $36.65 5,888 1
Gonzales, TX $24.50 $4.29 – $53.28 5,892 2
Altoona, PA $14.79 $2.68 – $120.38 5,900 6
Inez, KY $14.01 $12.28 – $25.15 5,902 3
Rosemead, CA $12.06 $0.00 – $35.16 5,905 6
Oakland City, IN $10.67 $8.25 – $13.52 5,905 2
Lincoln, RI $14.10 $0.67 – $37.29 5,906 9
Valley, AL $3.98 $1.94 – $5.04 5,908 4
Jefferson, OH $4.66 $4.57 – $8.58 5,911 3
Crawfordsville, IN $4.60 $0.96 – $5.96 5,913 3
Las Vegas, NM $21.80 $10.91 – $55.04 5,914 8
North Englewood, MD $46.99 $46.99 – $46.99 5,917 1
Clinton, MO $37.85 $16.03 – $77.45 5,920 6
Monrovia, CA $20.06 $13.20 – $32.21 5,936 4
Carthage, TX $5.18 $5.18 – $5.18 5,943 1
Richland, WA $13.87 $2.99 – $44.27 5,945 9
Stanford, KY $6.62 $0.07 – $7.77 5,946 3
Merion Station, PA $61.80 $7.14 – $71.35 5,951 2
Phenix City, AL $2.15 $0.00 – $4.19 5,953 2
Saint Augustine, FL $4.54 $0.00 – $9.04 5,954 4
Eatontown, NJ $9.02 $2.41 – $32.54 5,957 8
Minden, LA $1.71 $0.00 – $7.29 5,965 10
Cupertino, CA $15.21 $0.00 – $17.03 5,969 3
Blanding, UT $18.03 $14.26 – $21.81 5,973 2
Queens Village, NY $11.04 $0.00 – $20.86 5,985 5
Bartlesville, OK $15.84 $7.78 – $20.44 5,990 7
Boonton, NJ $3.15 $3.13 – $13.81 5,990 2
Tahlequah, OK $21.26 $21.26 – $21.26 5,992 1
Tarpon Springs, FL $3.04 $1.09 – $79.77 5,998 4
Stafford, TX $7.79 $6.83 – $14.42 5,998 2
Commack, NY $5.38 $0.00 – $9.30 6,013 6
Collins, MS $16.39 $7.22 – $22.72 6,016 5
Oak Park, MI $8.71 $5.55 – $8.72 6,019 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.