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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
Valhalla, NY $9.80 $4.86 – $48.23 10,897 6
Mayfield Hts, OH $11.73 $5.08 – $18.83 10,893 7
Ottawa, KS $5.68 $5.68 – $5.68 10,891 1
Great Falls, MT $26.42 $13.81 – $61.17 10,876 10
Sierra Vista, AZ $23.61 $18.90 – $24.45 10,865 6
Chester, NY $11.44 $11.44 – $11.44 10,836 1
Hudson, FL $11.72 $0.00 – $65.39 10,830 15
Minnetonka, MN $8.19 $0.00 – $58.11 10,821 16
Dover, FL $2.08 $2.08 – $2.08 10,813 1
Excelsior, MN $56.40 $51.07 – $71.45 10,811 5
Allen, TX $6.59 $2.98 – $16.01 10,803 6
Margate, FL $2.72 $2.55 – $7.40 10,799 3
Tuckahoe, NY $9.87 $9.87 – $9.87 10,793 1
Lansing, IL $15.55 $4.15 – $27.17 10,792 5
Amherst, VA $10.57 $8.93 – $11.34 10,787 3
Pocahontas, AR $16.92 $11.43 – $26.30 10,765 7
Portage, IN $30.50 $3.63 – $47.61 10,764 7
Bensalem, PA $22.52 $6.14 – $33.22 10,748 5
Fullerton, CA $18.82 $3.21 – $222.00 10,745 13
Colonia, NJ $43.58 $5.47 – $49.43 10,744 3
Caneyville, KY $5.62 $5.62 – $5.62 10,730 1
Niles, OH $15.47 $4.92 – $28.82 10,718 7
South Miami, FL $10.14 $1.15 – $18.02 10,709 11
Stoneham, MA $11.21 $3.87 – $24.24 10,690 5
Kaplan, LA $5.77 $4.44 – $8.55 10,687 3
Short Hills, NJ $10.30 $6.65 – $18.12 10,682 9
Garnerville, NY $5.38 $2.79 – $5.51 10,677 4
Media, PA $15.11 $6.06 – $83.44 10,665 14
Seminole, FL $10.61 $0.46 – $15.15 10,640 10
Phila, PA $21.64 $0.00 – $39.97 10,633 10
Springfield, PA $16.74 $0.00 – $22.15 10,620 8
Harrison, OH $11.44 $7.79 – $15.97 10,613 2
Annandale, VA $17.51 $8.00 – $20.46 10,612 6
Coconut Creek, FL $6.76 $5.09 – $35.99 10,588 6
Kalamazoo, MI $37.45 $8.42 – $43.11 10,581 7
Baldwyn, MS $22.26 $0.00 – $25.07 10,575 4
Woods Cross, UT $42.32 $42.32 – $42.32 10,556 1
Sycamore, IL $11.52 $3.99 – $16.95 10,555 9
Auburn, IN $6.68 $0.00 – $16.62 10,552 6
Westland, MI $26.71 $13.56 – $50.19 10,549 6
Matawan, NJ $11.32 $5.10 – $29.42 10,541 8
Groves, TX $3.86 $3.36 – $9.47 10,520 4
Brandenburg, KY $5.81 $2.27 – $9.63 10,511 4
Canandaigua, NY $10.69 $0.00 – $13.26 10,507 6
Twin Falls, ID $27.26 $10.76 – $39.72 10,502 8
Greenville, TX $16.47 $0.01 – $37.96 10,499 7
Floyd, VA $5.70 $3.28 – $5.71 10,487 2
Carlisle, MA $66.00 $66.00 – $66.00 10,480 1
Radford, VA $5.20 $5.05 – $23.63 10,477 3
Urbana, IL $12.18 $0.32 – $22.70 10,476 12

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.