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 |
|---|---|---|---|---|
| Hardinsburg, KY | $17.87 | $17.81 – $18.33 | 3,334 | 2 |
| Romney, WV | $0.40 | $0.00 – $13.10 | 3,332 | 4 |
| North Richland Hills, TX | $14.76 | $11.01 – $43.09 | 3,332 | 2 |
| Newfane, NY | $9.98 | $9.98 – $9.98 | 3,329 | 1 |
| Walpole, MA | $20.13 | $0.00 – $21.12 | 3,326 | 3 |
| South Hill, VA | $8.26 | $3.45 – $19.44 | 3,322 | 6 |
| Miamisburg, OH | $11.84 | $7.21 – $25.90 | 3,321 | 6 |
| Middlefield, CT | $6.77 | $6.77 – $6.77 | 3,321 | 1 |
| Lockport, NY | $11.38 | $0.99 – $19.63 | 3,320 | 5 |
| North Branford, CT | $13.72 | $13.72 – $13.72 | 3,318 | 1 |
| Clemmons, NC | $25.12 | $20.89 – $25.74 | 3,315 | 2 |
| Rialto, CA | $33.60 | $33.60 – $33.60 | 3,314 | 1 |
| Oregon, OH | $12.64 | $3.34 – $16.92 | 3,311 | 7 |
| Saranac Lake, NY | $7.73 | $7.72 – $9.63 | 3,310 | 2 |
| Freedom, CA | $7.43 | $3.08 – $8.85 | 3,309 | 3 |
| Bowling Green, VA | $10.69 | $6.55 – $25.10 | 3,306 | 4 |
| Oxford, OH | $16.05 | $14.18 – $22.50 | 3,305 | 3 |
| Lutz, FL | $3.54 | $0.00 – $36.91 | 3,303 | 7 |
| Gig Harbor, WA | $18.28 | $0.23 – $29.21 | 3,303 | 5 |
| Fairfield, OH | $11.32 | $1.26 – $13.62 | 3,301 | 6 |
| Columbia, MS | $18.30 | $4.51 – $27.39 | 3,301 | 7 |
| Fultondale, AL | $6.53 | $6.53 – $6.53 | 3,299 | 1 |
| Washington Washington, Dc, DC | $48.40 | $48.40 – $48.40 | 3,299 | 1 |
| Dawson Springs, KY | $21.16 | $18.11 – $28.21 | 3,298 | 3 |
| Willimantic, CT | $15.89 | $0.00 – $19.19 | 3,296 | 6 |
| Woburn, MA | $15.49 | $0.74 – $47.68 | 3,295 | 6 |
| Pawling, NY | $2.44 | $1.58 – $4.46 | 3,281 | 2 |
| Santa Clara, CA | $14.97 | $0.00 – $93.93 | 3,279 | 6 |
| Montpelier, VA | $3.45 | $3.45 – $3.45 | 3,279 | 1 |
| Mendenhall, MS | $15.62 | $14.67 – $15.65 | 3,277 | 2 |
| Yazoo City, MS | $38.64 | $6.71 – $77.52 | 3,276 | 4 |
| Valley Village, CA | $15.87 | $2.46 – $36.93 | 3,273 | 3 |
| Orangeburg, NY | $3.37 | $0.02 – $7.14 | 3,272 | 2 |
| Ellington, MO | $37.08 | $37.08 – $37.08 | 3,271 | 1 |
| Charlestown, MA | $6.58 | $2.98 – $11.51 | 3,270 | 4 |
| Martinsburg, WV | $16.65 | $13.05 – $17.71 | 3,266 | 4 |
| Dayton, TN | $9.50 | $0.13 – $18.84 | 3,263 | 6 |
| Hobart, OK | $31.09 | $31.09 – $31.09 | 3,259 | 1 |
| Cherokee Village, AR | $23.11 | $15.69 – $23.28 | 3,258 | 2 |
| Carrollton, KY | $16.38 | $9.93 – $37.88 | 3,258 | 3 |
| West Logan, WV | $21.16 | $21.16 – $21.16 | 3,257 | 1 |
| Watchung, NJ | $32.18 | $31.43 – $36.13 | 3,255 | 2 |
| Somerset, MA | $12.49 | $6.00 – $14.02 | 3,254 | 2 |
| Lacey, WA | $11.87 | $4.62 – $20.78 | 3,242 | 9 |
| Waynesville, NC | $5.95 | $5.17 – $22.61 | 3,242 | 3 |
| Patton, CA | $35.31 | $35.31 – $35.31 | 3,241 | 1 |
| Pittsburg, KS | $19.98 | $0.00 – $82.03 | 3,237 | 12 |
| Southern Pines, NC | $4.71 | $2.58 – $5.06 | 3,237 | 2 |
| Council Bluffs, IA | $19.07 | $0.00 – $35.65 | 3,232 | 9 |
| Simsbury, CT | $13.53 | $5.99 – $33.59 | 3,232 | 3 |
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.