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 — 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 |
|---|---|---|---|---|
| Lawrence, MA | $12.38 | $0.00 – $15.97 | 8,496 | 8 |
| Corsicana, TX | $7.22 | $0.00 – $9.87 | 8,479 | 8 |
| Woodbridge, NJ | $9.95 | $3.02 – $26.44 | 8,474 | 7 |
| Bay Springs, MS | $11.30 | $7.84 – $17.99 | 8,462 | 6 |
| Solon, OH | $13.67 | $3.93 – $21.43 | 8,454 | 10 |
| London, KY | $12.82 | $0.00 – $50.56 | 8,449 | 13 |
| Sanbornville, NH | $14.18 | $5.29 – $17.26 | 8,426 | 3 |
| Grand Terrace, CA | $16.52 | $16.52 – $16.52 | 8,421 | 1 |
| Massena, NY | $9.44 | $5.66 – $25.39 | 8,415 | 6 |
| Wauconda, IL | $21.27 | $19.03 – $52.13 | 8,405 | 5 |
| Fort Dodge, IA | $5.97 | $0.00 – $16.21 | 8,400 | 16 |
| New Martinsville, WV | $17.62 | $8.56 – $23.75 | 8,400 | 3 |
| Waupaca, WI | $20.42 | $1.23 – $71.31 | 8,395 | 20 |
| Biddeford, ME | $23.11 | $7.25 – $32.17 | 8,393 | 13 |
| Stroudsburg, PA | $17.13 | $0.00 – $21.89 | 8,388 | 5 |
| Glen Dale, WV | $12.50 | $10.08 – $12.55 | 8,385 | 2 |
| Coushatta, LA | $4.63 | $4.41 – $5.04 | 8,379 | 2 |
| Desloge, MO | $22.13 | $22.11 – $29.83 | 8,377 | 2 |
| Wellesley, MA | $13.36 | $1.46 – $16.14 | 8,366 | 5 |
| Bronxville, NY | $8.23 | $0.82 – $23.88 | 8,358 | 5 |
| Andover, MA | $11.57 | $3.12 – $14.73 | 8,351 | 5 |
| Brownfield, TX | $9.04 | $8.81 – $10.31 | 8,341 | 2 |
| Maysville, KY | $4.08 | $0.00 – $13.34 | 8,311 | 6 |
| Southgate, MI | $30.61 | $30.61 – $30.61 | 8,307 | 1 |
| Webster, TX | $7.95 | $0.00 – $20.66 | 8,298 | 20 |
| Lucedale, MS | $21.71 | $21.64 – $62.64 | 8,290 | 3 |
| Benson, NC | $19.55 | $7.43 – $20.16 | 8,289 | 2 |
| Plano, IL | $18.73 | $16.19 – $27.88 | 8,288 | 2 |
| Del Mar, CA | $17.60 | $17.60 – $17.60 | 8,287 | 1 |
| Palatine, IL | $9.04 | $0.55 – $23.29 | 8,286 | 13 |
| Clinton, TN | $12.46 | $12.43 – $13.81 | 8,284 | 2 |
| La Puente, CA | $14.94 | $0.00 – $34.41 | 8,284 | 4 |
| Bluefield, VA | $7.15 | $2.81 – $9.64 | 8,275 | 4 |
| Lyndhurst, NJ | $10.15 | $8.79 – $15.07 | 8,272 | 4 |
| East Moriches, NY | $3.48 | $1.80 – $3.78 | 8,265 | 2 |
| Ooltewah, TN | $11.60 | $4.23 – $13.20 | 8,249 | 4 |
| Alton, NH | $4.80 | $4.80 – $4.80 | 8,249 | 1 |
| North Manchester, IN | $6.62 | $1.73 – $7.69 | 8,244 | 2 |
| Binghamton, NY | $10.86 | $0.00 – $28.69 | 8,242 | 16 |
| Hammond, IN | $13.44 | $9.92 – $27.47 | 8,237 | 5 |
| Peekskill, NY | $2.31 | $1.20 – $2.86 | 8,228 | 4 |
| Visalia, CA | $6.67 | $0.00 – $16.43 | 8,214 | 16 |
| Port Royal, SC | $11.23 | $11.03 – $11.37 | 8,204 | 2 |
| Red Lake, MN | $12.25 | $12.25 – $12.25 | 8,202 | 1 |
| Dekalb, IL | $19.73 | $19.73 – $19.73 | 8,201 | 1 |
| Ridgefield Park, NJ | $5.92 | $1.71 – $7.73 | 8,187 | 8 |
| Bullhead City, AZ | $12.00 | $10.65 – $44.21 | 8,182 | 3 |
| Elk Grove, CA | $13.82 | $0.00 – $68.81 | 8,182 | 11 |
| Flagstaff, AZ | $25.93 | $0.41 – $62.76 | 8,178 | 12 |
| Wappinger Falls, NY | $5.02 | $5.02 – $5.02 | 8,157 | 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.