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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
Hartville, OH $0.00 $0.00 – $0.00 15 1
Homer, AK $31.03 $31.03 – $31.03 15 1
Fircrest, WA $0.00 $0.00 – $0.00 15 1
South Lake Tahoe, CA $23.00 $23.00 – $23.00 15 1
Kaneohe, HI $39.94 $39.94 – $39.94 15 1
Churubusco, IN $24.49 $24.49 – $24.49 15 1
Hometown, PA $0.00 $0.00 – $0.00 15 1
South Chesterfield, VA $20.69 $20.69 – $20.69 15 1
Edwardsville, IL $0.00 $0.00 – $0.00 15 1
Damariscotta, ME $92.18 $92.18 – $92.18 15 1
Osceola, MO $15.40 $15.40 – $15.40 15 1
Lewisport, KY $2.37 $2.37 – $2.37 15 1
Hastings On Hudson, NY $15.99 $15.99 – $15.99 15 1
Dallastown, PA $17.06 $17.06 – $17.06 15 1
Laurens, SC $11.41 $11.41 – $11.41 15 1
Due West, SC $41.44 $41.44 – $41.44 15 1
Eureka, MT $25.54 $25.54 – $25.54 15 1
Mount Arlington, NJ $9.17 $9.17 – $9.17 15 1
Jamestown, MI $0.15 $0.15 – $0.15 15 1
Chestertown, NY $4.26 $4.26 – $4.26 15 1
Washington, VA $0.00 $0.00 – $0.00 15 1
Bayard, NE $47.11 $47.11 – $47.11 15 1
Cardington, OH $8.49 $8.49 – $8.49 15 1
Laurel, NE $48.25 $48.25 – $48.25 15 1
Alford, FL $0.00 $0.00 – $0.00 15 1
Hico, TX $2.23 $2.23 – $2.23 15 1
Yoder, CO $10.79 $10.79 – $10.79 15 1
Ida, MI $0.00 $0.00 – $0.00 14 1
Vevay, IN $0.00 $0.00 – $0.00 14 1
Liberal, KS $6.53 $6.53 – $6.53 14 1
Decatur, TN $2.40 $2.40 – $2.40 14 1
Kingwood, WV $10.04 $10.04 – $10.04 14 1
White River Junction, VT $12.81 $12.81 – $12.81 14 1
Wheaton, MN $169.24 $169.24 – $169.24 14 1
Capitola, CA $23.98 $23.98 – $23.98 14 1
Caledonia, MN $23.20 $23.20 – $23.20 14 1
Moorpark, CA $12.00 $12.00 – $12.00 14 1
Jefferson, WI $4.78 $4.78 – $4.78 14 1
De Pere, WI $19.04 $19.04 – $19.04 14 1
Fremont, NE $19.46 $19.46 – $19.46 14 1
Mineral Wells, TX $28.60 $28.60 – $28.60 14 1
Bay Harbor Islands, FL $20.35 $20.35 – $20.35 14 1
Hampton, SC $35.40 $35.40 – $35.40 14 1
Moraga, CA $0.00 $0.00 – $0.00 14 1
Marlette, MI $10.28 $10.28 – $10.28 14 1
Green Lake, WI $8.78 $8.78 – $8.78 14 1
Vinton, IA $0.00 $0.00 – $0.00 14 1
Versailles, KY $16.14 $16.14 – $16.14 14 1
Eagle, CO $2.40 $2.40 – $2.40 14 1
Sault Sainte Marie, MI $49.82 $49.82 – $49.82 14 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.