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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
Colby, WI $80.97 $14.53 – $88.84 2,359 2
Alma, AR $14.33 $12.91 – $17.92 2,358 4
Kearny, NJ $12.41 $5.53 – $15.47 2,358 5
Camden, TN $11.55 $5.40 – $23.84 2,356 3
Shirley, NY $2.36 $2.36 – $2.36 2,354 1
Canoga Park, CA $9.32 $0.63 – $13.64 2,354 6
Cedar Park, TX $7.81 $0.00 – $13.32 2,353 6
Putnam, CT $18.49 $0.00 – $37.47 2,353 4
Olympia, WA $11.22 $0.26 – $33.61 2,352 9
Kent, OH $9.78 $0.10 – $21.82 2,351 4
Smithville, TN $5.75 $3.24 – $21.40 2,350 3
Parsons, TN $5.87 $3.52 – $7.62 2,347 3
Trenton, MO $27.69 $20.00 – $43.46 2,346 3
West End, NC $11.40 $8.72 – $19.88 2,346 2
Volente, TX $4.00 $4.00 – $4.00 2,345 1
Crossville, TN $23.33 $5.75 – $24.84 2,341 3
Greenfield, OH $4.74 $4.74 – $4.74 2,341 1
Rancho Palos Verdes, CA $16.00 $5.63 – $22.76 2,341 6
Lancaster, TX $3.62 $3.62 – $3.62 2,341 1
Pittsfield, ME $17.54 $17.54 – $17.54 2,337 1
King George, VA $5.11 $5.11 – $5.11 2,337 1
Tiffin, OH $10.61 $2.05 – $20.62 2,335 6
Tylertown, MS $14.21 $0.00 – $16.46 2,335 3
Plainfield, NH $10.72 $10.72 – $10.72 2,335 1
West Stewardstown, NH $9.93 $9.93 – $9.93 2,334 1
Manchester, IA $8.72 $0.00 – $8.98 2,329 2
Falmouth, MA $15.78 $14.62 – $26.93 2,329 3
Daniels, WV $18.53 $18.53 – $18.53 2,327 1
Natick, MA $6.00 $4.55 – $14.33 2,326 2
Mc Ewen, TN $13.35 $13.35 – $13.35 2,325 1
Waverly, TN $5.95 $3.48 – $7.42 2,325 3
Griffith, IN $10.60 $9.64 – $10.82 2,324 2
Robersonville, NC $12.94 $12.94 – $12.94 2,323 1
Newton, NJ $11.98 $5.86 – $24.60 2,320 5
East Rutherford, NJ $6.84 $6.84 – $6.84 2,319 1
Franklin, WI $14.38 $10.26 – $29.45 2,318 5
Fairfield, IL $1.74 $1.74 – $1.74 2,318 1
Trevose, PA $15.54 $3.25 – $28.25 2,318 2
Bradley, IL $21.28 $5.22 – $34.00 2,317 5
Mount Gilead, OH $5.31 $5.31 – $5.31 2,312 1
Chatham, IL $15.37 $11.06 – $15.66 2,312 2
Mammoth Spring, AR $20.19 $8.68 – $20.30 2,310 2
Port Hueneme, CA $51.35 $11.81 – $52.48 2,309 2
Provincetown, MA $15.68 $15.68 – $15.68 2,309 1
Battle Creek, MI $33.06 $23.63 – $51.15 2,308 3
Milan, MO $28.52 $28.02 – $88.53 2,308 2
Comanche, TX $4.67 $3.09 – $16.23 2,307 3
Reidsville, NC $7.28 $0.76 – $21.86 2,306 3
Lillington, NC $31.01 $12.02 – $37.84 2,306 3
Rossville, GA $13.54 $13.54 – $13.54 2,306 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.