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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
Rochdale, MA $18.25 $9.09 – $26.28 2,138 3
Myakka City, FL $4.82 $4.82 – $4.82 2,137 1
Pinson, AL $4.33 $4.03 – $4.67 2,136 2
Woodville, MS $27.60 $24.26 – $58.18 2,135 2
Waterville, ME $19.37 $11.98 – $24.74 2,134 4
Antioch, CA $32.03 $7.52 – $33.29 2,129 3
Inchelium, WA $27.65 $27.65 – $27.65 2,129 1
North Woodmere, NY $4.16 $4.16 – $4.16 2,128 1
Ogdensburg, NY $3.51 $1.85 – $4.13 2,127 2
Fordyce, AR $19.47 $19.47 – $19.47 2,126 1
Bismarck, MO $44.28 $44.28 – $44.28 2,122 1
San Tan Valley, AZ $18.84 $0.00 – $42.05 2,118 6
Newberg, OR $14.06 $0.00 – $31.41 2,118 5
Beckemeyer, IL $1.19 $0.97 – $5.84 2,118 2
Moundridge, KS $6.40 $1.45 – $16.40 2,116 5
Stoughton, MA $19.02 $19.02 – $19.02 2,115 1
Colfax, LA $12.63 $12.63 – $12.63 2,114 1
Mason, WV $8.90 $8.90 – $8.90 2,114 1
Lakeside, CA $12.16 $0.97 – $23.26 2,113 3
Tilton, IL $18.15 $18.15 – $18.15 2,113 1
Coatesville, PA $9.09 $4.61 – $41.66 2,107 3
Ceredo, WV $10.17 $10.17 – $10.17 2,107 1
Audubon, PA $25.07 $19.01 – $27.46 2,105 2
Halethorpe, MD $14.28 $0.98 – $17.89 2,103 4
Arroyo Grande, CA $2.34 $0.85 – $6.29 2,101 4
Ferdinand, IN $6.08 $6.08 – $6.08 2,098 1
Craigsville, VA $9.48 $9.48 – $9.48 2,095 1
Odessa, MO $28.72 $28.72 – $28.72 2,088 1
Caribou, ME $1.09 $1.09 – $1.09 2,085 1
Sequim, WA $15.06 $5.46 – $15.91 2,085 2
Dillon, SC $15.22 $0.00 – $18.50 2,083 4
Dublin, CA $14.59 $14.59 – $14.59 2,083 1
Union, KY $10.29 $10.25 – $10.91 2,082 2
Newport, RI $18.74 $1.83 – $21.38 2,081 2
Mount Carroll, IL $8.77 $2.99 – $8.93 2,077 2
Winchester, MA $18.15 $3.49 – $21.39 2,073 6
Chesterland, OH $7.12 $7.12 – $7.12 2,073 1
Byhalia, MS $11.99 $11.99 – $11.99 2,071 1
Frankfort, IN $9.88 $9.88 – $9.88 2,070 1
Orem, UT $8.70 $0.00 – $37.52 2,069 5
Woodinville, WA $21.88 $10.04 – $29.37 2,069 3
Alvin, TX $12.38 $2.05 – $20.56 2,068 4
New Carlisle, IN $6.89 $4.04 – $13.24 2,067 2
Brookpark, OH $19.61 $19.61 – $19.61 2,064 1
Mount Ayr, IA $16.51 $5.71 – $23.88 2,063 6
Lowell, IN $6.67 $1.97 – $6.80 2,062 2
Fairbanks, AK $18.37 $17.75 – $98.50 2,061 2
St Cloud, MN $56.23 $53.69 – $75.08 2,060 3
Acworth, GA $4.34 $4.34 – $4.34 2,058 1
Hohenwald, TN $14.32 $2.88 – $15.75 2,058 2

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.