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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
Vero Beach, FL $7.93 $0.00 – $26.63 42,934 30
Marina Del Rey, CA $24.65 $0.00 – $27.56 42,923 8
Temple Terrace, FL $6.75 $0.00 – $32.24 42,702 26
Pinellas Park, FL $10.57 $0.00 – $19.32 42,650 11
Brownsville, TX $5.96 $0.00 – $12.83 42,380 21
Oakwood, OH $18.05 $2.55 – $20.24 42,300 12
Avon, IN $10.31 $5.79 – $16.71 42,262 5
Las Cruces, NM $42.42 $0.00 – $76.27 42,187 27
Blue Ash, OH $15.61 $2.95 – $29.70 42,117 18
Marion, IN $10.21 $0.59 – $19.39 42,086 10
Panama City, FL $4.94 $0.00 – $49.91 42,037 23
New Albany, IN $7.21 $0.00 – $36.37 41,781 21
Old Saybrook, CT $10.80 $3.45 – $53.54 41,743 16
North Haven, CT $17.49 $5.44 – $97.76 41,736 9
Owings Mills, MD $35.69 $0.00 – $88.17 41,677 16
Beaumont, TX $4.59 $0.00 – $22.58 41,670 24
Hinsdale, IL $30.31 $2.50 – $48.67 41,547 13
Portland, ME $22.64 $0.00 – $60.17 41,534 54
Morristown, NJ $13.27 $0.00 – $26.41 41,515 26
West Des Moines, IA $11.04 $2.73 – $21.48 41,507 24
Morgantown, WV $16.92 $0.00 – $55.73 41,476 41
Delray Beach, FL $7.94 $0.00 – $94.10 41,258 23
Frisco, TX $7.85 $0.00 – $24.07 41,241 24
Southfield, MI $38.75 $4.36 – $66.99 41,163 22
Columbia, TN $8.92 $0.00 – $32.59 40,845 19
Florence, SC $10.66 $0.39 – $27.10 40,827 26
Hoffman Estates, IL $18.62 $4.98 – $63.02 40,821 15
Granger, IN $8.94 $3.76 – $15.11 40,795 9
Moseley, VA $13.16 $13.16 – $13.16 40,784 1
Middletown, NY $6.54 $0.45 – $78.32 40,700 29
Chesterfield, VA $8.42 $4.25 – $24.36 40,595 8
Stratford, CT $15.93 $4.36 – $39.32 40,579 16
North Babylon, NY $19.47 $0.00 – $41.18 40,541 17
Spartanburg, SC $15.68 $0.00 – $45.96 40,525 23
Quincy, MA $11.50 $0.00 – $33.32 40,507 19
Madison, AL $1.98 $0.00 – $16.56 40,490 21
New Rochelle, NY $8.18 $0.00 – $71.49 40,441 19
Teaneck, NJ $11.89 $0.00 – $41.39 40,276 25
Jenks, OK $12.32 $7.16 – $14.19 40,158 3
Kokomo, IN $10.52 $0.49 – $44.81 39,952 24
Selma, AL $3.81 $0.00 – $18.40 39,875 13
Maryville, TN $7.26 $1.01 – $11.32 39,868 21
Gore, OK $34.26 $22.13 – $56.35 39,791 3
Milford, CT $19.07 $0.06 – $58.23 39,718 15
Sunrise, FL $7.42 $0.00 – $53.51 39,712 23
Highland Park, IL $14.30 $0.00 – $32.85 39,685 17
Melville, NY $12.61 $3.77 – $18.84 39,600 3
New Iberia, LA $5.67 $0.00 – $12.89 39,582 8
Dandridge, TN $18.06 $1.27 – $23.87 39,557 7
Desoto, TX $7.90 $0.00 – $12.18 39,508 10

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.