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 |
|---|---|---|---|---|
| Methuen, MA | $21.57 | $1.72 – $27.37 | 3,229 | 4 |
| Monticello, IN | $5.13 | $5.13 – $5.13 | 3,227 | 1 |
| Celina, TN | $8.77 | $0.00 – $9.97 | 3,216 | 4 |
| Archbold, OH | $7.28 | $3.68 – $10.62 | 3,215 | 3 |
| Chester, PA | $14.60 | $0.00 – $45.12 | 3,213 | 5 |
| Lauderhill, FL | $3.40 | $0.00 – $4.77 | 3,212 | 3 |
| Wimberley, TX | $9.74 | $9.63 – $10.01 | 3,212 | 2 |
| Spring Valley, IL | $17.37 | $0.38 – $17.83 | 3,201 | 4 |
| Plainfield, NJ | $28.77 | $28.77 – $28.77 | 3,193 | 1 |
| Ocean, NJ | $4.83 | $3.22 – $21.07 | 3,191 | 8 |
| Darby, PA | $27.20 | $17.30 – $37.79 | 3,187 | 4 |
| Marlin, TX | $5.42 | $5.00 – $14.57 | 3,186 | 2 |
| Brightwaters, NY | $12.04 | $1.75 – $12.87 | 3,186 | 2 |
| Bayboro, NC | $18.90 | $15.99 – $26.92 | 3,185 | 3 |
| Wausau, WI | $13.42 | $0.00 – $16.89 | 3,181 | 12 |
| Menomonie, WI | $23.30 | $5.79 – $53.56 | 3,176 | 8 |
| San Juan, PR | $8.52 | $8.52 – $8.52 | 3,174 | 1 |
| Hodgenville, KY | $2.01 | $0.00 – $11.59 | 3,174 | 4 |
| Gillette, WY | $24.51 | $21.32 – $30.18 | 3,174 | 7 |
| Westport, CT | $3.29 | $2.76 – $12.64 | 3,172 | 3 |
| Warsaw, NY | $7.35 | $0.00 – $7.52 | 3,167 | 4 |
| Lake Wales, FL | $4.57 | $3.66 – $18.01 | 3,167 | 3 |
| Pennington Gap, VA | $14.03 | $1.79 – $17.81 | 3,165 | 6 |
| Collinsville, AL | $6.99 | $6.99 – $6.99 | 3,164 | 1 |
| Lexington, MS | $15.21 | $15.08 – $15.36 | 3,162 | 2 |
| Ozark, AL | $5.14 | $1.87 – $58.45 | 3,160 | 3 |
| Santa Cruz, CA | $21.93 | $0.00 – $33.16 | 3,152 | 8 |
| Auburn, AL | $4.38 | $1.09 – $11.05 | 3,144 | 4 |
| Wyoming, MN | $9.08 | $9.08 – $9.08 | 3,142 | 1 |
| Beverly Hills, FL | $20.65 | $3.73 – $96.63 | 3,140 | 2 |
| Wilton, NH | $5.67 | $5.67 – $5.67 | 3,138 | 1 |
| Markle, IN | $5.64 | $5.64 – $5.64 | 3,137 | 1 |
| Hanover, PA | $13.38 | $0.00 – $43.72 | 3,135 | 7 |
| Lebanon, PA | $13.18 | $2.76 – $23.17 | 3,135 | 8 |
| Carlton, MN | $27.88 | $27.88 – $27.88 | 3,135 | 1 |
| Fort Thomas, KY | $4.89 | $0.00 – $5.55 | 3,131 | 8 |
| Juneau, AK | $13.26 | $1.00 – $45.52 | 3,119 | 3 |
| Melbourne, AR | $17.60 | $11.62 – $21.16 | 3,119 | 3 |
| Winchester, KS | $10.72 | $10.72 – $10.72 | 3,119 | 1 |
| Queen Creek, AZ | $38.20 | $31.89 – $41.19 | 3,113 | 2 |
| Arnold, MD | $23.78 | $8.88 – $58.46 | 3,110 | 4 |
| Decatur, TX | $4.58 | $0.00 – $20.24 | 3,108 | 8 |
| Camp Hill, PA | $20.26 | $0.00 – $40.47 | 3,107 | 10 |
| Pompton Lakes, NJ | $15.04 | $14.92 – $16.54 | 3,101 | 2 |
| Holiday, FL | $8.09 | $4.16 – $11.06 | 3,100 | 4 |
| Hernando, FL | $9.71 | $9.30 – $15.85 | 3,099 | 2 |
| Wildwood, FL | $4.27 | $2.32 – $11.67 | 3,099 | 3 |
| Aberdeen, SD | $18.84 | $11.79 – $19.77 | 3,097 | 3 |
| Dade City, FL | $12.28 | $0.60 – $13.99 | 3,092 | 3 |
| Franklin, WV | $5.73 | $0.06 – $17.32 | 3,089 | 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.