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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
Travis Afb, CA $9.20 $9.20 – $9.20 1,054 1
Decatur, MS $27.71 $6.65 – $28.37 1,054 2
Warrenton, VA $5.86 $2.54 – $11.82 1,053 3
Richfield, OH $16.29 $15.64 – $28.03 1,053 2
Lagrange Park, IL $28.32 $28.32 – $28.32 1,053 1
Lecanto, FL $1.37 $0.57 – $2.79 1,051 3
Plymouth, NC $16.42 $8.78 – $22.62 1,051 3
Mamaroneck, NY $34.21 $3.36 – $40.71 1,048 3
Westwood, MA $11.33 $11.33 – $11.33 1,047 1
Colonial Beach, VA $12.65 $10.21 – $13.43 1,047 2
Connelly Springs, NC $5.93 $4.95 – $15.92 1,046 2
Marshall, MN $49.92 $35.27 – $71.37 1,045 3
Ackerman, MS $33.76 $14.04 – $62.15 1,045 4
Portales, NM $20.56 $17.76 – $27.39 1,043 3
Bear, DE $8.91 $0.43 – $51.08 1,043 4
Saint John, IN $11.29 $4.85 – $14.88 1,042 3
Clewiston, FL $9.27 $9.27 – $9.27 1,042 1
Bridge City, TX $9.34 $9.34 – $9.34 1,040 1
Drums, PA $2.64 $0.00 – $2.68 1,039 2
South San Francisco, CA $23.59 $0.00 – $46.87 1,038 4
Butte, MT $4.62 $0.00 – $25.64 1,037 3
Collinsville, OK $17.06 $17.06 – $17.06 1,036 1
Cressona, PA $19.34 $19.34 – $19.34 1,036 1
Rockford, AL $2.11 $2.11 – $2.11 1,036 1
Berwick, PA $12.61 $9.61 – $18.85 1,033 2
Port Huron, MI $26.17 $7.30 – $92.07 1,032 3
Bay City, TX $10.01 $7.84 – $11.59 1,031 4
Hainesport, NJ $5.10 $5.10 – $5.10 1,030 1
Belton, MO $7.33 $0.67 – $27.07 1,030 4
Hillside, NJ $19.39 $17.81 – $28.88 1,028 3
Indianola, MS $16.85 $16.85 – $16.85 1,028 1
Coppell, TX $13.12 $6.05 – $17.60 1,027 4
Nellysford, VA $15.39 $5.93 – $25.83 1,027 2
Powderly, KY $3.39 $0.85 – $6.35 1,027 2
South Houston, TX $3.27 $3.27 – $3.27 1,026 1
Platteville, WI $9.71 $9.71 – $9.71 1,026 1
Minneola, FL $6.19 $6.19 – $6.19 1,026 1
Booneville, KY $22.36 $22.14 – $36.97 1,025 3
Crystal, MN $66.30 $52.25 – $72.14 1,025 3
Woodbine, IA $5.05 $5.05 – $5.05 1,025 1
Woodlyn, PA $31.39 $31.39 – $31.39 1,023 1
Lake Village, AR $16.79 $16.79 – $16.79 1,019 1
Saint Elmo, IL $11.76 $11.76 – $11.76 1,018 1
Mcminnville, OR $17.53 $16.29 – $25.82 1,017 2
Huffman, TX $10.71 $10.71 – $10.71 1,016 1
Wareham, MA $12.87 $8.89 – $13.63 1,015 2
Espanola, NM $31.80 $31.36 – $59.01 1,015 2
Oak Harbor, WA $6.02 $0.00 – $12.14 1,014 3
Goleta, CA $24.45 $24.45 – $24.45 1,014 1
Worcester, NY $13.52 $13.52 – $13.52 1,012 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.