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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
Country Club Hills, IL $13.80 $13.80 – $13.80 1,206 1
Crane, TX $4.36 $4.36 – $4.36 1,206 1
Brookfield, CT $20.15 $16.27 – $29.44 1,205 4
Moscow, ID $26.71 $26.71 – $26.71 1,204 1
North Dighton, MA $4.50 $4.50 – $4.50 1,203 1
Iron River, MI $28.28 $27.66 – $49.27 1,201 3
Deming, NM $24.37 $24.36 – $25.04 1,201 2
Taylor, MI $32.30 $0.00 – $34.82 1,199 4
Clearfield, UT $45.25 $45.25 – $45.25 1,198 1
Reedsburg, WI $30.87 $7.35 – $36.65 1,197 2
Blaine, MN $10.47 $5.54 – $22.59 1,196 2
Maspeth, NY $26.70 $7.31 – $35.62 1,195 3
La Porte, TX $3.55 $3.55 – $3.55 1,194 1
Warsaw, MO $11.50 $0.95 – $26.26 1,193 2
Abbeville, SC $12.79 $12.79 – $12.79 1,191 1
Bennington, NE $8.79 $8.79 – $8.79 1,188 1
Chariton, IA $9.76 $0.00 – $14.96 1,187 3
Silverdale, WA $3.83 $0.00 – $10.77 1,186 5
Nocona, TX $5.81 $5.81 – $5.81 1,185 1
Jasper, TN $6.09 $2.39 – $8.30 1,184 2
Van Buren, AR $11.41 $9.04 – $19.88 1,184 3
Debary, FL $14.58 $12.20 – $14.60 1,183 2
Salem, CT $26.94 $26.94 – $26.94 1,182 1
Mcconnelsville, OH $16.49 $15.55 – $16.70 1,182 2
Bomoseen, VT $7.78 $0.00 – $12.92 1,181 4
Fairborn, OH $4.93 $1.58 – $23.15 1,180 2
Cuba, NM $38.34 $16.48 – $49.66 1,179 2
Albany, MO $11.25 $10.88 – $39.81 1,178 2
Winona, MN $55.69 $28.88 – $74.59 1,177 8
Beech Grove, IN $17.26 $4.18 – $18.71 1,176 2
Scottsbluff, NE $28.31 $14.29 – $35.17 1,175 4
Cameron, WV $16.82 $16.82 – $16.82 1,175 1
Paragould, AR $13.34 $7.11 – $22.61 1,174 4
Holland, IN $7.38 $7.38 – $7.38 1,173 1
Loxahatchee, FL $10.27 $3.87 – $20.22 1,172 4
South Attleboro, MA $1.51 $1.45 – $2.65 1,172 2
Sterling, IL $11.54 $1.29 – $16.10 1,171 5
Midfield, AL $4.08 $4.08 – $4.08 1,171 1
Weldon Spring, MO $15.03 $15.03 – $15.03 1,168 1
Massapequa Park, NY $3.89 $3.16 – $21.93 1,167 2
Bell, FL $3.48 $3.48 – $3.48 1,167 1
Horse Cave, KY $37.55 $32.88 – $48.90 1,163 3
Zavalla, TX $8.70 $8.70 – $8.70 1,163 1
Albert Lea, MN $48.83 $36.00 – $63.12 1,162 3
Bloomington, MN $78.02 $51.90 – $80.35 1,160 4
Marysville, WA $6.57 $1.23 – $13.31 1,160 3
Murrells Inlet, SC $12.11 $2.81 – $26.04 1,159 3
Ferguson, MO $19.31 $19.31 – $19.31 1,159 1
Middletown, KY $6.95 $6.95 – $6.95 1,159 1
Beebe, AR $14.56 $14.56 – $14.56 1,159 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.