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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
Missouri Valley, IA $4.65 $0.37 – $20.01 826 2
Loranger, LA $17.00 $17.00 – $17.00 826 1
West Chester Township, OH $12.32 $12.32 – $12.32 826 1
Adamstown, PA $13.02 $13.02 – $13.02 825 1
Soledad, CA $14.84 $0.00 – $19.63 824 2
Markleville, IN $2.19 $2.19 – $2.19 823 1
Onancock, VA $13.94 $12.06 – $17.74 822 2
Holland Patent, NY $4.46 $4.46 – $4.46 820 1
Chalmette, LA $11.82 $7.04 – $18.69 819 3
Senatobia, MS $7.05 $7.05 – $7.05 817 1
Amite, LA $20.13 $0.00 – $21.50 817 3
Dexter, MO $25.81 $23.26 – $75.03 816 3
Nebo, NC $22.36 $16.00 – $22.87 816 2
Clayton, MO $0.35 $0.00 – $0.40 814 2
Grambling, LA $5.69 $5.69 – $5.69 814 1
Rantoul, IL $19.85 $19.85 – $19.85 813 1
Sanford, ME $19.33 $0.82 – $20.96 813 2
Dunn, NC $11.29 $0.00 – $24.43 812 4
Haynesville, LA $0.08 $0.00 – $3.52 812 4
Lemont, IL $6.65 $6.27 – $8.75 812 2
Roseville, IL $6.38 $6.38 – $6.38 812 1
Gainesville, TX $8.11 $8.11 – $8.11 811 1
Fort Polk, LA $11.12 $11.12 – $11.12 810 1
Fredericksburg, PA $6.03 $0.53 – $7.49 809 3
Village Of Palmetto Bay, FL $0.39 $0.39 – $0.39 808 1
Hollister, MO $28.50 $28.50 – $28.50 807 1
Florence, MA $37.30 $37.30 – $37.30 807 1
Manchester, OH $23.80 $23.80 – $23.80 806 1
Mayaguez, PR $9.85 $8.97 – $10.00 805 2
Bloomfield, MO $41.07 $41.07 – $41.07 805 1
Greensboro, AL $0.07 $0.07 – $0.07 805 1
Greer, SC $18.63 $2.79 – $26.43 804 4
Windham, ME $21.74 $14.15 – $45.08 804 3
Hebron, NE $13.67 $9.91 – $25.98 804 2
Kendall Park, NJ $2.03 $2.00 – $2.22 803 2
Grove Hill, AL $0.07 $0.07 – $0.07 803 1
Castine, ME $44.48 $44.48 – $44.48 803 1
Spanaway, WA $17.71 $15.35 – $50.40 802 2
Waverly, NY $10.20 $9.41 – $12.42 800 2
Glen Rose, TX $8.91 $0.30 – $72.07 799 3
Lynnwood, WA $8.67 $1.62 – $42.84 799 4
Eutaw, AL $6.17 $0.00 – $7.68 799 2
Howard Beach, NY $15.49 $6.72 – $16.58 799 2
Meadowbrook, PA $4.32 $0.08 – $16.44 797 3
Mitchellville, MD $44.62 $44.62 – $44.62 796 1
Tehachapi, CA $12.91 $12.25 – $27.09 794 2
Sunrise, Fl, FL $6.31 $6.31 – $6.31 794 1
Rockland, ME $0.52 $0.52 – $0.52 793 1
Antigo, WI $35.23 $35.23 – $35.23 793 1
Madisonville, TN $7.42 $2.54 – $7.54 793 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.