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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
Corbin, KY $16.19 $0.48 – $97.86 29,945 16
Denison, TX $9.08 $7.08 – $23.44 29,908 5
Pinehurst, NC $14.40 $3.11 – $21.32 29,870 11
Sunnyvale, CA $8.96 $1.87 – $12.82 29,848 7
Brentwood, TN $15.63 $0.00 – $60.79 29,846 22
Parkville, MD $68.34 $0.00 – $100.83 29,821 23
Wadsworth, OH $13.78 $7.34 – $21.19 29,775 8
Erie, PA $13.45 $0.00 – $32.36 29,721 29
Lilburn, GA $7.65 $3.35 – $32.58 29,693 3
Cape Girardeau, MO $18.99 $1.70 – $61.13 29,637 15
Chipley, FL $7.42 $4.19 – $9.13 29,468 2
Enterprise, AL $8.78 $0.47 – $20.65 29,452 18
Elkridge, MD $32.69 $8.65 – $81.59 29,437 14
Randallstown, MD $43.30 $6.32 – $74.25 29,419 14
Westerville, OH $13.47 $4.64 – $37.98 29,333 17
North Miami, FL $8.64 $1.75 – $46.69 29,266 20
Mc Kenzie, TN $11.47 $0.00 – $15.28 29,088 9
Hickory, NC $9.00 $0.77 – $22.08 29,054 11
Collinsville, IL $13.15 $5.00 – $15.22 29,032 3
Milton, MA $11.84 $10.43 – $21.77 29,009 7
Schaumburg, IL $18.11 $1.82 – $43.71 28,958 24
Ansted, WV $17.45 $11.46 – $19.97 28,943 3
Springfield, OR $9.32 $8.38 – $25.96 28,902 6
Niagara Falls, NY $14.15 $3.87 – $17.71 28,895 9
Denver, NC $18.91 $5.64 – $25.92 28,883 6
Zephyrhills, FL $4.00 $0.00 – $17.19 28,868 21
Greenville, MS $32.29 $0.00 – $181.47 28,861 16
Woodbridge, VA $12.87 $2.00 – $36.94 28,752 18
Vineland, NJ $7.52 $0.00 – $22.32 28,730 16
Newton, MA $10.76 $2.95 – $19.55 28,719 7
Southaven, MS $15.09 $4.12 – $137.85 28,716 14
Clarksville, TN $10.49 $1.74 – $46.04 28,668 20
Old Bridge, NJ $13.24 $1.88 – $29.48 28,627 20
Chapin, SC $22.82 $8.06 – $43.87 28,627 7
Princeton, WV $12.77 $0.81 – $14.27 28,614 6
Mineola, NY $8.89 $2.25 – $34.53 28,595 13
Valley Stream, NY $6.62 $0.00 – $32.02 28,509 14
Parsippany, NJ $10.96 $1.95 – $17.36 28,447 13
Clinton, SC $14.47 $9.85 – $19.34 28,424 5
Bayonne, NJ $8.76 $0.78 – $15.15 28,371 11
Abbeville, LA $1.48 $0.00 – $4.96 28,322 6
Ewing, NJ $10.04 $1.36 – $18.87 28,282 12
Creve Coeur, MO $23.96 $6.09 – $25.04 28,153 8
Edinburg, TX $8.49 $0.35 – $49.34 28,123 20
Ontario, CA $34.26 $4.09 – $70.43 28,083 11
Coral Springs, FL $5.35 $0.00 – $55.80 28,069 18
Golden Valley, MN $44.66 $12.74 – $80.37 28,029 26
Burlington, NC $10.95 $2.97 – $39.08 27,937 16
Cape May Court House, NJ $11.56 $0.89 – $38.34 27,859 8
Doral, FL $4.25 $0.72 – $104.96 27,857 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.