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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
Union City, NJ $15.96 $4.37 – $25.11 21,083 13
Brighton, MA $12.30 $1.02 – $36.21 21,037 9
Chillicothe, OH $11.81 $3.53 – $34.14 20,986 20
Sleepy Hollow, NY $2.94 $0.00 – $7.04 20,982 3
Fairfield, CT $20.45 $0.15 – $43.37 20,953 11
Mcminnville, TN $28.29 $0.00 – $32.17 20,934 6
Marion, VA $8.41 $5.86 – $19.95 20,906 6
Sylva, NC $7.74 $1.96 – $29.47 20,888 7
Westport, MA $11.97 $11.01 – $24.30 20,882 2
Maitland, FL $5.61 $0.00 – $15.79 20,830 12
Glenview, IL $12.04 $1.12 – $57.27 20,759 21
Anthem, AZ $32.52 $19.74 – $49.87 20,723 5
Holmdel, NJ $24.03 $3.08 – $57.36 20,717 12
Fort Smith, AR $21.19 $6.35 – $87.42 20,714 23
Marianna, FL $8.61 $2.93 – $44.76 20,685 19
Tarzana, CA $34.43 $2.38 – $571.66 20,627 15
Freehold, NJ $11.18 $0.15 – $35.45 20,563 22
Lexington, SC $22.47 $8.91 – $75.95 20,558 16
Gary, IN $17.03 $3.13 – $34.63 20,526 13
Harrisonburg, VA $13.68 $5.67 – $40.98 20,486 10
Wheelersburg, OH $7.30 $2.35 – $11.37 20,468 7
Hilliard, OH $12.00 $8.45 – $16.43 20,453 7
Florissant, MO $16.01 $0.00 – $29.24 20,451 11
Ft Lauderdale, FL $5.40 $0.00 – $76.02 20,447 10
Winnsboro, LA $0.59 $0.00 – $19.77 20,438 6
Gray, GA $2.53 $1.22 – $3.43 20,431 2
Opelousas, LA $4.66 $0.00 – $9.95 20,423 11
N Chelmsford, MA $12.78 $11.50 – $16.32 20,403 3
West Chester, OH $11.37 $0.09 – $22.05 20,380 13
East Longmeadow, MA $15.73 $7.25 – $21.58 20,331 5
Wytheville, VA $6.91 $2.35 – $10.05 20,316 3
Summerville, SC $16.15 $5.25 – $60.33 20,310 15
Sebring, FL $5.64 $0.50 – $10.93 20,310 9
East Falmouth, MA $8.94 $5.27 – $24.14 20,304 3
Fairmont, WV $14.06 $2.01 – $28.65 20,283 14
Huntington Beach, CA $10.67 $0.00 – $46.79 20,275 19
Rockingham, NC $16.23 $0.00 – $19.83 20,250 4
Marks, MS $26.59 $18.62 – $49.01 20,210 3
Dublin, VA $11.09 $8.36 – $13.08 20,193 3
Tullahoma, TN $12.35 $0.00 – $27.58 20,191 15
Albany, NY $8.39 $0.00 – $39.88 20,157 30
Jacksboro, TN $29.28 $2.89 – $36.36 20,134 6
North Royalton, OH $12.14 $11.32 – $19.98 20,106 4
Rolla, MO $38.82 $17.36 – $67.62 20,081 7
Harrisonville, MO $19.39 $18.99 – $28.98 20,070 2
Dyer, IN $10.81 $0.00 – $45.21 20,057 11
San Angelo, TX $5.56 $1.15 – $12.10 20,029 10
Merced, CA $22.22 $0.66 – $31.92 20,024 7
La Follette, TN $8.68 $2.98 – $12.72 20,020 7
Umatilla, FL $6.58 $5.83 – $8.05 19,992 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.