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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
Tucker, GA $11.11 $4.24 – $41.58 47,821 8
Fayetteville, NC $17.82 $0.00 – $44.70 47,764 29
Concord, NH $4.24 $0.00 – $34.18 47,661 28
Inglewood, CA $26.83 $2.66 – $59.94 47,510 27
Hamden, CT $22.40 $0.00 – $46.06 47,471 27
Centerville, OH $15.94 $5.95 – $26.11 47,404 23
Fort Pierce, FL $7.03 $0.00 – $110.37 47,247 24
Westlake, OH $12.60 $3.81 – $30.64 47,131 32
Trinity, FL $6.64 $0.00 – $60.20 47,129 22
Independence, MO $16.87 $1.43 – $74.27 47,126 20
Odessa, TX $6.19 $1.71 – $42.27 47,082 10
Rockville Centre, NY $9.05 $0.00 – $51.24 46,851 18
Salem, MA $15.27 $1.21 – $32.66 46,827 16
Fountain Valley, CA $22.96 $0.68 – $222.00 46,742 21
Voorhees, NJ $12.12 $0.00 – $51.09 46,728 52
Burr Ridge, IL $15.06 $4.16 – $98.44 46,598 19
Lombard, IL $10.51 $0.00 – $46.94 46,424 20
Fairfax, VA $10.46 $1.32 – $136.55 46,225 26
Hopkinsville, KY $16.72 $0.19 – $72.20 46,215 10
Pleasanton, TX $3.53 $0.00 – $6.05 46,178 4
Rocky Hill, CT $22.45 $0.00 – $54.82 45,750 22
Petaluma, CA $23.40 $0.00 – $248.31 45,638 9
Stafford, VA $10.39 $3.03 – $22.62 45,605 11
Kansas City, KS $10.72 $0.00 – $37.71 45,550 27
Franklin, TN $14.16 $2.40 – $36.73 45,508 23
Canton, MA $13.24 $4.46 – $24.31 45,418 13
Fishersville, VA $9.97 $2.45 – $16.72 45,386 16
Casa Grande, AZ $37.37 $16.90 – $56.95 44,982 8
Hawthorne, CA $10.98 $0.40 – $24.11 44,971 7
Terre Haute, IN $11.50 $0.00 – $21.65 44,938 22
Carson City, NV $19.19 $11.00 – $80.91 44,935 16
Franklin Square, NY $16.70 $4.93 – $24.40 44,778 8
Newport Beach, CA $12.02 $0.00 – $53.95 44,768 19
East Hartford, CT $36.32 $5.23 – $56.88 44,644 13
Old Tappan, NJ $13.61 $7.56 – $13.61 44,581 2
Beavercreek, OH $11.71 $0.00 – $24.62 44,288 12
Muncie, IN $8.70 $0.00 – $19.40 43,984 20
Lakewood, NJ $11.27 $0.00 – $31.80 43,900 39
Danville, VA $7.76 $2.12 – $22.66 43,827 16
Palm Bay, FL $7.30 $1.62 – $32.68 43,821 15
Fair Oaks, CA $9.43 $0.00 – $16.59 43,636 12
Lanham, MD $24.57 $0.00 – $80.71 43,559 18
Poplar Bluff, MO $27.52 $8.58 – $65.84 43,550 23
Bristol, TN $12.07 $3.72 – $20.28 43,470 10
Wolcott, CT $25.82 $4.98 – $36.34 43,465 7
Mayfield Heights, OH $12.78 $1.12 – $21.26 43,402 10
Abingdon, VA $10.58 $2.71 – $22.58 43,367 9
Shelby Township, MI $23.82 $23.82 – $23.82 43,252 1
Willowbrook, IL $29.20 $8.65 – $119.63 42,993 16
Greenwood, IN $19.94 $1.31 – $57.63 42,942 29

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.