Nursing facility Medicaid rates by code
1 nursing facility codes with published Medicaid rates in five or more states. Each page compares every state's rate, unit and managed-care rule.
- Codes
- 1
- In 40+ states
- 0
All nursing facility codes
| Code | Service | States | Median rate |
|---|---|---|---|
| G9685 | Physician service or other qualified health care... | 6 | $114.91 |
What the nursing facility line covers
The nursing facility line groups the codes billed mostly by nursing facilities. Across the 51 state programs we cover, 1 code in this line have a published fee-for-service rate in five or more states. By code set, the line is made up of 1 HCPCS Level II professional services code.
How to read the index
- Code opens the code's page: every state's rate ranked, the unit, a per-hour figure for timed codes, the managed-care rule and a Medicare comparison where the units match.
- States is the number of state Medicaid programs that publish a fee-for-service rate for the code. A higher count makes the median more representative.
- Median rate is the middle published amount across those states, in the units they use. When states publish a code in different units, the median mixes them, so open the code before relying on it.
Why nursing facility rates differ between states
- Nursing facility rates are usually set per facility from cost reports and adjusted for the acuity of the residents, so a state figure is a reference point.
Billing and units
Nursing facility care is paid per resident day.
Frequently asked questions
How many nursing facility codes have Medicaid rates here?
1 codes with a published fee-for-service rate in at least five state Medicaid programs. The typical code in this line is published by 6 states.
Which nursing facility codes are published by the most states?
G9685 (6 states).
Can I compare the median rates in this list?
Only with care. Each median is taken across the states that publish the code, in the units they publish it in. Open a code to see the unit each state uses and whether the code is ranked like-for-like.
How are nursing facility services billed?
Nursing facility care is paid per resident day.
Where do these rates come from?
From each state's official Medicaid fee schedules, rate notices and provider bulletins. Every rate on a code page links to its source document and effective date.