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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
Durango, CO $32.71 $3.02 – $67.80 17,136 11
Deland, FL $5.46 $0.30 – $13.24 17,118 10
New Bern, NC $37.89 $3.14 – $47.18 17,117 7
Alpena, MI $30.87 $0.00 – $39.62 17,115 3
Powell, TN $24.71 $9.08 – $30.95 17,083 3
Santa Barbara, CA $14.59 $0.00 – $60.19 17,081 18
Massillon, OH $11.31 $1.39 – $30.12 17,076 15
Union, OH $20.38 $20.38 – $20.38 17,051 1
Oak Creek, WI $12.09 $3.42 – $12.95 17,030 2
Mandeville, LA $2.09 $0.00 – $2.94 17,010 5
Agawam, MA $8.87 $7.52 – $26.67 16,998 5
Petal, MS $12.58 $4.06 – $28.41 16,997 5
Lakewood, CA $17.41 $4.08 – $26.37 16,951 8
Bedford, TX $5.70 $0.00 – $363.40 16,945 7
Barrington, IL $11.59 $3.29 – $44.60 16,936 8
Logan, OH $10.15 $3.79 – $22.69 16,901 3
East Rockaway, NY $8.69 $5.29 – $11.16 16,900 2
Denton, TX $7.70 $0.00 – $64.81 16,897 16
Aurora, OH $9.26 $5.91 – $9.26 16,896 2
Ft Worth, TX $8.11 $0.39 – $30.67 16,893 6
Salyersville, KY $7.07 $3.65 – $9.41 16,867 4
Rowlett, TX $16.62 $13.84 – $27.25 16,861 5
Middle River, MD $24.90 $16.04 – $42.46 16,845 2
Sparks, NV $19.31 $8.61 – $67.83 16,838 12
Gardena, CA $11.29 $5.25 – $27.92 16,796 12
Roselle Park, NJ $23.24 $0.95 – $40.61 16,791 10
Albemarle, NC $26.12 $3.98 – $35.94 16,789 10
Grand Forks, ND $27.99 $0.00 – $63.82 16,780 20
Live Oak, CA $8.71 $1.54 – $9.27 16,767 3
Garden City, NY $9.38 $2.40 – $11.97 16,754 5
Brunswick, ME $19.62 $8.29 – $26.96 16,741 8
Deer Park, NY $4.45 $0.00 – $22.16 16,740 8
Elkhart, IN $6.74 $3.01 – $10.75 16,724 8
Manakin Sabot, VA $13.49 $13.49 – $13.49 16,706 1
Shelby, NC $16.27 $9.35 – $32.99 16,692 11
Houlton, ME $26.24 $26.24 – $26.24 16,672 1
Madera, CA $15.44 $0.00 – $29.54 16,654 5
Hasbrouck Heights, NJ $11.49 $6.30 – $13.08 16,632 3
Watsonville, CA $17.22 $4.33 – $36.61 16,629 6
Rich Creek, VA $7.84 $7.16 – $8.88 16,627 2
Etowah, TN $5.07 $4.44 – $8.24 16,622 5
Reisterstown, MD $22.73 $0.00 – $65.32 16,615 6
Chase City, VA $12.98 $8.72 – $14.40 16,574 3
Mission, TX $7.33 $4.54 – $23.73 16,567 7
Victorville, CA $11.97 $0.00 – $51.88 16,559 9
Aliquippa, PA $26.54 $15.14 – $50.98 16,558 9
Norwood, MA $10.16 $4.76 – $30.64 16,545 10
Paramount, CA $9.95 $0.00 – $42.53 16,520 9
Lancaster, PA $15.16 $0.53 – $54.12 16,510 22
Hillsboro, OR $14.19 $0.00 – $74.26 16,509 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.