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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
Huntley, IL $18.65 $3.01 – $24.72 10,468 4
Norwalk, CA $19.11 $2.45 – $34.03 10,453 17
Ashland, VA $22.67 $22.67 – $22.67 10,432 1
Mt Pleasant, SC $15.79 $0.00 – $22.92 10,410 5
Maryland Heights, MO $23.67 $14.77 – $26.47 10,391 4
Hollins, VA $14.55 $14.55 – $14.55 10,375 1
Martinsville, VA $9.81 $7.31 – $16.28 10,367 11
Islamorada, FL $4.64 $4.64 – $4.64 10,366 1
Centerville, IA $8.55 $0.00 – $21.64 10,364 22
Wenatchee, WA $13.34 $5.17 – $33.42 10,363 7
South Holland, IL $15.39 $3.38 – $26.24 10,359 6
Edenton, NC $16.30 $3.50 – $16.55 10,346 3
Winfield, IL $12.40 $3.86 – $24.53 10,343 8
Elk Grove Village, IL $10.80 $0.00 – $27.99 10,339 17
Decatur, IL $11.30 $2.72 – $35.19 10,330 12
Mattoon, IL $14.73 $6.70 – $38.42 10,313 10
East Palestine, OH $10.61 $4.08 – $10.80 10,305 5
Danville, KY $12.20 $1.87 – $62.78 10,298 6
Newton Highlands, MA $8.56 $7.40 – $25.11 10,284 3
La Jolla, CA $16.41 $0.00 – $33.43 10,275 19
Mount Vernon, NY $12.26 $0.00 – $43.01 10,264 15
El Cajon, CA $12.63 $0.00 – $105.95 10,243 11
Findlay, OH $8.74 $3.28 – $16.06 10,239 8
Upper Marlboro, MD $42.85 $17.78 – $87.27 10,236 10
Perryville, AR $15.21 $13.71 – $23.90 10,230 5
Deltona, FL $5.28 $1.19 – $9.21 10,210 8
Sellersburg, IN $6.84 $4.99 – $7.85 10,206 2
Troy, IL $24.01 $22.28 – $29.88 10,202 3
Colquitt, GA $12.89 $12.89 – $12.89 10,201 1
El Dorado, AR $12.44 $9.45 – $16.85 10,174 6
Galion, OH $15.51 $0.00 – $86.37 10,173 8
North Wales, PA $33.94 $8.44 – $75.05 10,144 7
Deerfield Beach, FL $3.87 $0.70 – $59.07 10,136 12
Boscawen, NH $2.73 $0.71 – $3.51 10,128 2
Hueytown, AL $11.24 $0.96 – $21.03 10,120 4
Troy, OH $14.59 $7.64 – $28.86 10,116 10
La Vergne, TN $18.86 $5.32 – $23.68 10,113 2
Kirkland, IL $18.93 $18.93 – $18.93 10,105 1
Lowell, MA $11.11 $0.83 – $44.82 10,103 16
Sparta, NC $8.86 $8.68 – $11.94 10,102 2
Eureka, CA $53.09 $6.73 – $205.68 10,098 8
Hammonton, NJ $25.33 $1.65 – $49.86 10,091 6
Howell, NJ $14.86 $1.34 – $20.64 10,089 8
Dyer, TN $5.81 $5.81 – $5.81 10,084 1
Sedona, AZ $15.49 $15.49 – $15.49 10,073 1
Texas City, TX $5.79 $4.80 – $12.54 10,068 6
Mt. Laurel, NJ $8.83 $8.47 – $9.73 10,064 3
Mchenry, IL $20.24 $0.00 – $22.85 10,052 9
Deerfield, IL $9.81 $2.73 – $22.15 10,049 6
Takoma Park, MD $36.81 $4.81 – $61.46 10,046 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.