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 |
|---|---|---|---|---|
| Eatontown, NJ | $9.02 | $2.41 – $32.54 | 5,957 | 8 |
| Saint Augustine, FL | $4.54 | $0.00 – $9.04 | 5,954 | 4 |
| Phenix City, AL | $2.15 | $0.00 – $4.19 | 5,953 | 2 |
| Merion Station, PA | $61.80 | $7.14 – $71.35 | 5,951 | 2 |
| Stanford, KY | $6.62 | $0.07 – $7.77 | 5,946 | 3 |
| Richland, WA | $13.87 | $2.99 – $44.27 | 5,945 | 9 |
| Carthage, TX | $5.18 | $5.18 – $5.18 | 5,943 | 1 |
| Monrovia, CA | $20.06 | $13.20 – $32.21 | 5,936 | 4 |
| Clinton, MO | $37.85 | $16.03 – $77.45 | 5,920 | 6 |
| North Englewood, MD | $46.99 | $46.99 – $46.99 | 5,917 | 1 |
| Las Vegas, NM | $21.80 | $10.91 – $55.04 | 5,914 | 8 |
| Crawfordsville, IN | $4.60 | $0.96 – $5.96 | 5,913 | 3 |
| Jefferson, OH | $4.66 | $4.57 – $8.58 | 5,911 | 3 |
| Valley, AL | $3.98 | $1.94 – $5.04 | 5,908 | 4 |
| Lincoln, RI | $14.10 | $0.67 – $37.29 | 5,906 | 9 |
| Rosemead, CA | $12.06 | $0.00 – $35.16 | 5,905 | 6 |
| Oakland City, IN | $10.67 | $8.25 – $13.52 | 5,905 | 2 |
| Inez, KY | $14.01 | $12.28 – $25.15 | 5,902 | 3 |
| Altoona, PA | $14.79 | $2.68 – $120.38 | 5,900 | 6 |
| Gonzales, TX | $24.50 | $4.29 – $53.28 | 5,892 | 2 |
| Tolleson, AZ | $36.65 | $36.65 – $36.65 | 5,888 | 1 |
| New Berlin, WI | $11.88 | $11.72 – $29.30 | 5,883 | 2 |
| Pompano Beach, FL | $5.09 | $0.89 – $42.89 | 5,882 | 8 |
| Des Peres, MO | $8.26 | $8.26 – $8.26 | 5,882 | 1 |
| East Windsor, NJ | $7.42 | $2.06 – $7.52 | 5,881 | 3 |
| Sharon, PA | $19.15 | $5.85 – $26.88 | 5,880 | 3 |
| Maynardville, TN | $11.97 | $0.03 – $19.90 | 5,873 | 3 |
| Monroe Twp, NJ | $7.82 | $1.18 – $15.33 | 5,872 | 3 |
| West Hills, CA | $21.43 | $0.00 – $37.01 | 5,870 | 10 |
| Midland, TX | $6.21 | $0.91 – $10.71 | 5,868 | 4 |
| Boonville, MO | $24.73 | $16.13 – $39.75 | 5,868 | 2 |
| Fort Sam Houston, TX | $8.25 | $6.17 – $30.78 | 5,865 | 3 |
| Pelham, AL | $10.18 | $2.00 – $18.30 | 5,862 | 3 |
| Dearborn Heights, MI | $44.21 | $43.58 – $61.94 | 5,862 | 3 |
| Erin, TN | $8.69 | $7.33 – $9.02 | 5,862 | 4 |
| Colonial Heights, VA | $9.05 | $2.56 – $16.01 | 5,857 | 6 |
| Skowhegan, ME | $20.26 | $18.61 – $22.75 | 5,855 | 3 |
| Martins Ferry, OH | $5.65 | $3.79 – $15.23 | 5,853 | 4 |
| Roselle, NJ | $13.54 | $6.99 – $16.82 | 5,848 | 3 |
| Lehigh Acres, FL | $2.05 | $0.00 – $7.48 | 5,843 | 5 |
| Haxtun, CO | $33.02 | $33.02 – $33.02 | 5,839 | 1 |
| Midland, PA | $12.40 | $12.40 – $12.40 | 5,838 | 1 |
| Shipshewana, IN | $4.53 | $4.09 – $5.55 | 5,832 | 2 |
| Fairfax Station, VA | $11.18 | $11.18 – $11.18 | 5,832 | 1 |
| West Brentwood, NY | $7.63 | $7.63 – $7.63 | 5,824 | 1 |
| Weslaco, TX | $14.70 | $0.00 – $376.31 | 5,822 | 14 |
| Big Stone Gap, VA | $14.85 | $4.94 – $20.74 | 5,821 | 4 |
| Riverhead, NY | $6.04 | $1.57 – $14.92 | 5,809 | 5 |
| Avon, OH | $5.96 | $2.58 – $11.48 | 5,803 | 3 |
| Salem, OR | $16.57 | $0.27 – $28.50 | 5,795 | 16 |
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.