Medicaid Nursing Home Rates by State

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Georgia

Medicaid nursing facility payment · Cost-based · researched October 2026

Georgia’s Medicaid agency and its state plan are the official source for these rules. This page summarizes them as researched in October 2026; check the state’s own documents, listed under Sources, before relying on them.

At a glance

Rate method

Cost-based

Case-mix level

Facility average

Classification

PDPM

Rate updates

Quarterly

Managed care (LTC)

No

Quality program

QIP add-on + Quality Supplement

Paid outside the rate

Small

Bed hold

Hospital and leave

Published rates

Rates and build‑ups

Assisted living

Covered

Personal needs allowance

$70 / month

Overview

• Georgia pays each home a rate built from its own audited cost report, with each cost center capped at a peer-group ceiling (a percentile of all homes' costs).
• The nursing cost center (Routine and Special Services) is case-mix adjusted every quarter using the home's average PDPM nursing score for its Medicaid residents.
• Add-ons go on top: an efficiency bonus for homes under the ceilings, a dementia (BIMS) add-on, a staffing/quality add-on of up to 8%, and the nursing home provider fee ($17.10/day) passed back in the rate.
• Capital is paid by fair rental value.
• SFY2027 rates (from 7/1/2026) use June 30, 2024 cost reports with a 0% growth (inflation) allowance.
• The October 1, 2026 rate list covers 344 homes: median $277.04/day, range $170.87-$385.00.

What matters in Georgia

• 0% inflation allowance every year since 7/1/2022; rate growth comes only from rebasing to newer cost reports.
• Case mix is per home, reset quarterly from the Medicaid residents' average PDPM nursing score.
• Up to 8% staffing and quality add-on and up to 5.5% dementia add-on, both applied to the nursing per diem.
• Under 5% of pay is outside the rate: a $36.25M/yr quality supplement plus IGT payments to government-owned homes.
• $707.54/day flat all-inclusive rate for prior-authorized ventilator-dependent residents since 7/1/2023.
• Bed hold pays 75% of the rate, excluding the $17.10 provider fee, for up to 7 days per hospital stay.

Frequently asked

Does Georgia include an inflation allowance in Medicaid nursing home rates?

No. The allowance has been 0% every year since 7/1/2022, so rate growth comes only from rebasing to newer cost reports.

Does Georgia pay more for residents with severe dementia?

Yes. A dementia add-on of up to 5.5% is applied to the nursing per diem, alongside a staffing and quality add-on of up to 8%.

How much does Georgia Medicaid pay to hold a bed during a hospital stay?

Bed hold pays 75% of the rate, excluding the $17.10 provider fee, for up to 7 days per hospital stay.

How much is paid outside the posted rate in Georgia?

Small, probably under 5% of base: the quality supplement plus IGT-funded payments to government-owned homes.

What does Georgia Medicaid pay on Medicare coinsurance days?

Medicaid pays coinsurance only up to its own per diem, so homes usually receive little or none.

Does Georgia require a minimum share of spending on care?

No; but spending below the ceilings lowers future rates at the next rebase.

How is the Georgia nursing home provider tax charged?

$17.10 per non-Medicare day, with federal and state homes exempt, returned as a fixed $17.10/day line in the rate.

How the rate is set

How the method got here

Verified October 11, 2026

Cost basis

Uses cost reports

Yes

Cost report

Georgia 'Nursing Home Cost Report Under Title XIX' (state-specific Medicaid cost report, June 30 fiscal year), audited by DCH's contractor (Myers and Stauffer), plus a separate GL-PL Insurance Supplemental Report for liability insurance costs.

Base year and rebasing

Rebased nearly every year since 2021, subject to appropriations. The manual says DCH will update the base cost report 'a minimum of every two years provided budget appropriations.' Base by rate year: SFY2022 = FY2019 cost reports (first rebase since FY2012, with a one-year hold-harmless); SFY2023 = FY2020; SFY2024 = FY2021; SFY2025 = FY2022; SFY2026 = FY2023; SFY2027 (from 7/1/2026) = June 30, 2024 cost report and FY2024 GL-PL report. July 2018 through June 2021 used FY2012 cost reports with a $147/day minimum rate (7/2019-6/2021). (Manual 1002.2.1-1002.2.15.)

Components

Component	Method	Notes
Routine and Special Services (nursing)	Audited cost per day, divided by the home's base-period PDPM nursing case-mix index for all residents, capped at the 90th percentile of all nursing facilities. The result is multiplied by the home's latest quarterly Medicaid-resident PDPM index.	Statewide standard (case-mix-neutral) on the Oct 2026 rate sheets: $121.00. Example (Park Place, Oct 2026): cost $147.41/day, divided by 1.6386 = $89.96, times quarterly Medicaid CMI 1.5939 = $143.39. One peer group for all NFs (ICF/IID separate).
Dietary	Cost per day capped at the 90th percentile for freestanding homes and the 60th percentile for hospital-based homes.	Oct 2026 standards: $31.73 for freestanding (298 sheets); $41.20 for hospital-based (33 sheets). Not case-mix adjusted.
Laundry, Housekeeping and Operation & Maintenance of Plant	Cost per day capped at a percentile ceiling. The manual text says 85th percentile; the R-32 rate sheet header shows 90%.	Oct 2026 standard $35.91.
Administrative and General	Cost per day, excluding liability insurance, capped at 105% of the peer-group median.	Oct 2026 standard $39.61. Home-office salaries are limited (e.g. a $100,000 cap for owner/related-party executives).
Supplemental A&G - General and Professional Liability Insurance	Pass-through of audited cost per day from the GL-PL Insurance Supplemental Report. No ceiling.	Separate since 7/1/2018.
Property and Related (FRV)	Fair rental value; see capital.	Example $14.31/day (Park Place, Oct 2026).
Taxes and Insurance (property)	Audited cost per day, outside the FRV.	The manual lists a Taxes and Insurance standard per diem, but the rate sheets show none (N/A).
Efficiency add-on	(Standard minus net per diem) x 75% for each cost center, paid only when cost is below the standard and above 15% of it. Capped per cost center: R&SS $0.53, Dietary $0.22, L&H/Plant $0.41, A&G $0.37, Property $0.40.	At most about $1.93/day in total.

Inflation

A 'growth allowance' percentage set by appropriation and applied to the four non-property cost centers. It has been 0% from 7/1/2022 through SFY2027 (rate sheets: 'Growth Allowance: 0.00%'). It was 5% in SFY2022 and 13.37% in SFY2020-2021. Rate increases since 2022 come from rebasing to newer cost reports instead. Return on equity is 0%.

Verified October 11, 2026

Case mix

System

PDPM

Applied at

Facility average

How it works

Each home gets one rate per quarter. Its nursing (Routine and Special Services) per diem is multiplied by the average PDPM nursing index of the Medicaid residents in the building on the last day of the quarter, so every Medicaid resident in that home is paid the same rate (manual 1002.3.1; R-32 rate sheets).

Classification

PDPM nursing component only (25 groups, A-Y). Georgia uses its own '2022 indices' in Appendix D Exhibit 1. It does not use the PT, OT, SLP or NTA components, because those costs are mostly paid by Medicare Part B/D or outside the per diem. There are two weight sets: 'all patients' (used to neutralize base cost) and 'Medicaid patients', which are about 2% higher (e.g. ES3 3.95 vs 4.03; PA1 0.64 vs 0.65), which keeps paying 'extra funds for Medicaid-only patients'. Before 7/1/2024 Georgia used RUG-III 34-group with an index maximizer.

Applies to

Routine and Special Services (nursing) only. Dietary, L&H/plant, A&G, liability insurance, FRV and taxes are not case-mix adjusted.

Acuity measured from

Neutralization uses the base-period average for all residents (e.g. 1.6386). Payment uses the quarterly average for Medicaid residents, using each resident's most recent MDS on the last day of the quarter (picture dates 3/31, 6/30, 9/30, 12/31). Payer is taken from the MDS Medicaid ID or 'Medicaid pending', and homes can correct it. Residents more than 3 months overdue for an assessment are dropped. The statewide Medicaid average on the Oct 2026 sheets was 1.5055 (1.5356 'with RUG weight options'). If a home has too few Medicaid MDS records, the statewide average may be used (1002.6.5).

Updated

Quarterly (Jan 1, Apr 1, Jul 1, Oct 1). Each rate uses the case-mix picture from two quarters earlier: the 10/1/2026 rate used data for the quarter ending 6/30/2026.

Move to PDPM

Georgia did not adopt the Optional State Assessment. It ran PDPM 'shadow rates' (for illustration only) for 7/2023-4/2024. The 4/1/2024 rates carried forward the 1/1/2024 RUG-based rates, with incentive updates only. Official PDPM nursing-component case mix began 7/1/2024, using MDS data as of 3/31/2024. It was a one-step switch with no blend. DCH said the formula did not change ('PDPM values will be used in place of the RUG-III values'). No budget-neutrality statement was found.

Verified October 11, 2026

Low-acuity residents

None. Georgia has no reduced or flat rate for low-acuity residents. Payment is one facility-average rate per quarter. Residents in the lowest PDPM nursing groups (PA1 at 0.65 and PA2 at 0.70 on the Medicaid weights) only pull down the home's average Medicaid CMI; they are not paid at a separate lower rate. Residents who don't meet NF level of care are not eligible for NF Medicaid at all (pre-admission review), rather than being paid less. Checked: NF manual Ch. 1000 (Oct 2026), Appendix D and Exhibit 1, the PDPM presentation (11/2023), and the R-32 rate sheets.

Verified October 11, 2026

Capital

Fair rental value since 7/1/2012 (manual 1002.8). Value per sq ft comes from the RSMeans national nursing-home construction cost, adjusted by an RSMeans location factor for the zip code: $244.83 (2023 RSMeans) for SFY2026, updated to 2024 RSMeans for SFY2027 (8/19/2026 revised rate letter). Allowed square footage is the lesser of actual or 700 sq ft per licensed bed. Equipment is $6,000 per bed. Depreciation is 2% per year of adjusted age, with age capped at 25 years (so up to 50%). Land is 15% of facility value. Rental rate is 9.0% (since 7/1/2009). The annual amount is divided by the greater of actual resident days or 85% of licensed beds x 365. Age is reduced for bed additions and renovations over $500 per licensed bed, effective the quarter after DCH approval (60-day review). Property taxes and insurance are paid separately at cost. The FRV efficiency incentive is capped at $0.40.

Verified October 11, 2026

Budget adjustment factor

0% growth (inflation) allowance every year since 7/1/2022, including SFY2027 (DCH labels each rate set '0% Growth'). Rate growth instead comes from moving to a newer cost-report year. No explicit budget-neutrality factor appears on the rate sheets. Historical: a $147/day minimum rate floor 7/2019-6/2021; a one-year hold-harmless at the FY2019 rebase (SFY2022); and SFY2022 'Emergency SPA' rate listings (COVID era).

Verified October 11, 2026

Add-ons and money outside the rate

Paid outside the posted rate

Level

small

Estimate

Probably under 5% of base. The quality supplement ($36.25M/yr) is about 1.5% of an estimated $2.4B/yr in Medicaid NF base payments (344 homes, median rate $277; the Medicaid day count is our assumption, about 24,000 residents). The UPL/IGT payments go only to the small number of government-owned homes, and their dollar amounts are not published. The QIP and BIMS add-ons are inside the posted rate, so they are not off-rate money.

Components

Supplemental Quality Incentive Payments $36.25M/yr (SFY2025-2027); government-owned NF UPL payments (IGT-funded, quarterly; size not published).

Source

https://dch.georgia.gov/document/document/cmslongstayqualitym…

Verified October 11, 2026

Payments by owner type

Applies

yes

Detail

Government-owned or operated NFs (state and non-state, such as county or hospital-authority homes) can get quarterly UPL rate adjustments up to what Medicare principles would pay. Private homes cannot. State-owned NFs are paid 100% of service cost. Hospital-based NFs get a higher dietary ceiling (but a 60th-percentile cap) and are grouped separately. The number of homes and dollar gap were not published.

Funding

IGT from the public owner to DCH before each payment ('Notice of Intent to Transfer'; no transfer means no payment). No lease or management arrangement for private operators was found.

Source

https://dch.georgia.gov/providers/provider-types/nursing-home…

Verified October 11, 2026

Quality program

Program

Two parts. (1) The Quality Improvement Initiative Program (QIP): a per diem add-on to the nursing cost center for staffing and quality points, accreditation and AHCA awards (manual 1002.7). (2) Supplemental Quality Incentive Payments: an annual lump sum for improvement on CMS long-stay quality measures (manual 1009; SPA GA 21-0009 and GA 24-0012).

Funding

(1) The QIP add-on is built into the FFS rate from the regular appropriation, not a separate pool. (2) The supplemental payment is a state appropriation with federal match: $36,253,776/yr ($12M state) for SFY2025, SFY2026 and SFY2027. The June 2026 notice lists $43,771,848 ($15M state) for SFY2026, but the Sept 2025 notice lists $36.25M, so this is inconsistent. It started at $115M in SFY2022 (COVID-era).

Size

(1) QIP: 1% staffing + 1-7% quality, applied to the case-mix-adjusted nursing per diem. Example: 5% of $143.39 = $7.17/day. In Oct 2026 the combined staffing/quality percentage was 5% at 136 homes, 3% at 110, 2% at 36, 4% at 30, 6% at 20, 1% at 6, 0% at 4 and 7% at 2. (2) Supplement: $36.25M/yr.

Paid as

(1) QIP: a per diem add-on to the Routine and Special Services line, reset quarterly. (2) Supplement: a lump sum once a year.

Measures

Measure	Source	Weight	How points are earned
Staffing add-on: nursing hours per patient day >= 2.50 (state minimum 2.00)	State quarterly Nursing Hours and Patient Days Report	1% of R&SS allowed per diem	Meets the 2.50 expected hours
QIP clinical points: high-risk long-stay pressure sores; long-stay restraints; long-stay moderate/severe pain; short-stay new/worsened pressure ulcers; influenza vaccine; falls with major injury (NRC Health alternatives for low-volume homes)	MDS QM (CMS website)	1 point each	Better than the statewide average
QIP non-clinical points: employee satisfaction survey participation; family satisfaction 'would recommend' >= 85% excellent/good; RN/LPN stability; CNA stability; AHCA Bronze award	State/vendor surveys, staffing report, AHCA	1 point each	At or above the state average
QIP tiers		3 points (at least 1 clinical + 1 non-clinical) = 1%; 6 points (at least 3 clinical + 1 non-clinical) = 2%	Extra: AHCA Silver +1% (cap 4%), AHCA Gold +2% (cap 5%), Joint Commission accreditation +2% (cap 7%)
Supplement: long-stay residents who lose too much weight (404)	MDS QM (CMS)	share of pool by improvement rank	Improvement vs prior calendar year
Supplement: long-stay UTI (407)	MDS QM (CMS)	share by rank	Improvement vs prior CY
Supplement: long-stay antipsychotic use (481)	MDS QM (CMS)	share by rank	Improvement vs prior CY
Supplement: long-stay falls with major injury (410)	MDS QM (CMS)	share by rank	Improvement vs prior CY

Scoring period

QIP: the 'most current data available' each quarter. The 10/1/2026 rates used staffing data for the quarter ending 6/30/2026. Supplement: calendar-year improvement vs the prior CY, paid in the following SFY (CY2026 vs CY2025, paid in SFY2027; CY2027 paid in SFY2028).

Payment formula

QIP: percentage of the case-mix-adjusted R&SS per diem (staffing 1% + quality 1-7%). Supplement: each measure is ranked by improvement, and payment is 'proportional to improvement' (the highest improver gets the most). Before CY2024 payments were ranked by decile of percent improvement. The exact dollar formula is not published.

Eligibility

QIP: must enroll and meet 2.50 nursing hours for the staffing add-on. Homes on CMS's Special Focus list lose the 1% quality incentive until two surveys in a row show nothing above scope/severity level E, or CMS removes them. Supplement: must improve on at least 1 measure, have 50% or more Medicaid long-term residents, and be in good standing.

Cadence

QIP: quarterly with each rate. Supplement: annually.

Scores published

QIP: partly. The quarterly rate listing flags AHCA Bronze/Silver/Gold and Joint Commission per home, and the R-32 sheets show each home's BIMS and staffing/quality percentages. Supplement: an archived payments page exists (https://dch.georgia.gov/providers/provider-types/nursing-home…); per-facility amounts were not verified.

Notes

Measures for the supplement have changed several times: CY2021-2023 used pressure ulcers, antianxiety/hypnotics, antipsychotics and UTI; CY2024 dropped pressure ulcers; CY2025 onward uses weight loss, UTI, antipsychotics and falls.

Verified October 11, 2026

Provider tax

Charged

per non-Medicare day

Standard amount

$17.10 per non-Medicare patient day (shown on the Apr-Jun 2026 non-Medicaid provider fee report form and on the Oct 2026 R-32 rate sheets; effective date of this amount not found).

Tiers

Who	Test	Amount
Federal and state government-owned nursing homes	public	exempt
Homes by 'number or percentage of medically indigent patients served' (per DCH's page and the statute's wording); no reduced tier was observed on the rate sheets. 323 of 344 sheets show $17.10, and 11 show $0.00 (likely state/exempt homes)	medicaid_utilization	statute allows the per-day fee to vary; no current reduced amount found

Lower for high-Medicaid homes

no

Returned in the rate

A fixed $17.10/day add-on in the Medicaid per diem (R-32 line 23, 'Nursing Home Provider Fee'). It is left out of the leave/bed-hold rate.

Source

https://dch.georgia.gov/providers/provider-types/nursing-home…

Verified October 11, 2026

Provider tax notes

Nursing Home Provider Fee Act (O.C.G.A. 31-8-160 et seq., effective 7/1/2003). $17.10 per non-Medicare patient day (all payers except Medicare, including private pay), paid monthly and reported quarterly. Federal and state facilities are exempt. The Medicaid share is returned as a $17.10/day line in each home's Medicaid rate (R-32 line 23). Leave and bed-hold days are not taxed, and their rate excludes the fee.

Verified October 11, 2026

Supplemental payments

(1) UPL rate adjustments for government-owned or operated NFs, both state and non-state, funded by intergovernmental transfers (IGT) from the eligible public owners (manual 1005; DCH NH supplemental reimbursement page). Paid quarterly in interim and final rounds; e.g. the SFY2025 2nd interim payment required the IGT by 10/9/2025 and paid on 10/23/2025. Gap: up to what Medicare payment principles would pay. Amounts are not published on the page. (2) State-owned NFs are adjusted to 100% of service costs (1002.11). (3) Supplemental Quality Incentive Payments, $36.25M/yr (see quality_incentive).

Verified October 11, 2026

Other add-ons

(1) BIMS/cognitive add-on: percentage of the case-mix-adjusted nursing per diem, by share of Medicaid residents with BIMS <= 5 (or CPS moderately severe to very severe): <20% = 0%, 20-<30% = 1%, 30-<45% = 2.5%, 45%+ = 5.5%. In Oct 2026: 2.5% at 129 homes, 1% at 105, 0% at 62, 5.5% at 35. (2) Staffing 1% and QIP quality 1-7% (see quality_incentive). (3) Efficiency add-on, up to about $1.93/day. (4) Provider fee pass-through, $17.10/day. (5) Nurse aide training and testing: up to $738 per aide certified, with interim payments of $0.25 per Medicaid day quarterly (1007).

Verified October 11, 2026

Units paid separately

(1) Ventilator-dependent residents: flat all-inclusive $707.54/day (since 7/1/2023), prior-authorized by the Medical Management Contractor and re-reviewed every 90 days; costs reported as a distinct part (1008). (2) ICF/IID are grouped separately with their own standards. (3) State-owned NFs: 100% of cost. (4) New homes: lower of projected cost or 90% of ceilings plus FRV; newly built homes over 50 beds get 95% of standards; after a change of ownership the new owner keeps the prior owner's rate until its own cost report is usable. (5) Unauditable cost reports: lowest of the last rate, the calculated rate, or 90% of standards.

Verified October 11, 2026

Payment rules

Managed care for long-term care

Status

no

Detail

Fee-for-service; Georgia Families plans do not carry nursing home long-term care

Verified October 11, 2026

Who pays

fee_for_service. Nursing facility long-term care is paid by DCH directly at the facility rate (GAMMIS FFS claims). The Georgia Families care management organizations (CMOs) do not carry the NF long-term care benefit. The provider-fee report has a separate line for Medicaid CMO patient days and revenue, which suggests a small number of CMO-paid days (e.g. short stays after a hospital transfer). Source: DCH NF manual Part II Ch. 1000; provider fee single-site instructions.

Verified October 11, 2026

Managed care rate floor

Not applicable for NF long-term care, which is paid fee-for-service. No CMO NF rate floor was found.

Verified October 11, 2026

Included in the daily rate

The per diem covers room, board, nursing and routine services and supplies. Prescription drugs are billed separately to the Medicaid pharmacy program or Medicare Part D. Lab and radiology are paid through the Medicaid fee schedule. Most therapy for dual eligibles is billed to Medicare Part B; Medicaid therapy cost in the rate is 'a few dollars a day'. Portable x-ray is billed separately (Appendix U). Sources: PDPM presentation (11/2023) slides 12-13; NF manual Ch. 900.

Verified October 11, 2026

Bed hold

Hospital stays

Paid for up to 7 consecutive days per hospital stay at 75% of the on-site rate, excluding the provider fee: (rate - $17.10) x 0.75. Example: $286.65 rate -> $202.16 bed-hold rate.

Leave days

Up to 8 days per calendar year (ordered by a physician in the plan of care), at the same 75% rate excluding the provider fee. ICF/IID: 30 days per year.

Occupancy rule

None found.

Notes

The quarterly rate listing posts a separate 'Leave/BH Rate' for each home. Families may pay the home to hold a bed beyond the limits, up to the full per diem.

Source

https://www.mmis.georgia.gov/portal/Portals/0/StaticContent/P…

Verified October 11, 2026

Personal needs allowance

Per month

70

Effective

2019-07 (PAMMS Chart A1.9: 'Effective 7-19')

Notes

DFCS PAMMS Appendix A1, 2026 ABD Financial Limits, Chart A1.9: PNA for an individual in a nursing home or institutionalized hospice is $70 (effective 7-19); $90 for a VA pensioner or surviving spouse with no dependents whose VA check is reduced to $90. Earlier steps were $50 -> $65 (2018) -> $70 (2019). Not COLA-indexed.

Confidence

confirmed

Source

https://pamms.dhs.ga.gov/dfcs/medicaid/appendix-a1/2026-abd-l…

Verified October 11, 2026

Medicare coinsurance days

Method

lesser_of

Rule

Lesser-of. Section 1004: the most Medicaid will pay on a Medicare NF coinsurance (crossover) claim is the home's Medicaid per diem for those dates. Crossovers are not re-adjusted when rates change later. Medicare Advantage cost-sharing is not addressed in the NF manual.

Effect

On Part A days 21-100, Medicaid pays coinsurance only up to its own rate. Because the Medicare SNF rate usually exceeds the Medicaid rate, the home usually receives little or none of the coinsurance (the exact netting formula is not stated).

Source

https://www.mmis.georgia.gov/portal/Portals/0/StaticContent/P…

Medicare Advantage

not addressed: NF Services manual (Q4 Oct 2026) Sec. 1004 caps Medicare NF coinsurance (crossover) claims at the home's Medicaid per diem, with no later re-adjustment. The manual has no Medicare Advantage or Part C text.

Medicare Advantage source

https://www.mmis.georgia.gov/portal/Portals/0/StaticContent/P…

Verified October 11, 2026

Required care spending

Applies

no

Rule

No rule requires homes to spend a share of Medicaid revenue on care. Related but different: a minimum 2.00 nursing hours per patient day (condition of participation, enforced with penalties, not recoupment) and 2.50 hours to earn the 1% staffing add-on. Because rates are cost-based with percentile ceilings, spending below the ceiling lowers future rates at the next rebase (efficiency bonus is at most 75% of the gap, tightly capped).

Source

https://www.mmis.georgia.gov/portal/Portals/0/StaticContent/P…

Verified October 11, 2026

Occupancy rules

Applies

yes

Rule

FRV (capital): the annual rental amount is divided by the greater of actual resident days or 85% of licensed beds x 365, so homes below 85% occupancy get less capital per day. No occupancy test was found for the operating cost centers (actual days are used) or for bed-hold pay.

Source

https://www.mmis.georgia.gov/portal/Portals/0/StaticContent/P…

Verified October 11, 2026

MDS accuracy penalties

No specific case-mix accuracy penalty schedule was found. MDS and payer-source corrections from appeals or audits are made by adjusting a later period's rate, or by retroactive recoupment if significant (Appendix D.E(xx)). DCH says homes 'should be able to support' PDPM data elements if audited. There is a $10/day late fee for the quarterly nursing hours report.

Verified October 11, 2026

Published rates and changes

How often rates change

A home's rate changes

quarterly

When

Jan 1, Apr 1, Jul 1, Oct 1 (case mix, quality, dementia); annual rebase Jul 1

Verified October 11, 2026

When rates change

Quarterly: Jan 1, Apr 1, Jul 1 and Oct 1 (case mix and QIP/BIMS updates). Annual rebase and FRV update on July 1 (state fiscal year). FRV renovation or bed-addition changes take effect the first day of the quarter after approval. Revised rates are reprocessed by DCH; e.g. the July 1, 2026 rates were revised 8/19/2026 for the 2024 RSMeans FRV update, with appeals due 9/19/2026.

Verified October 11, 2026

Posted rates

Home-level rates published

Yes

Where

https://dch.georgia.gov/providers/provider-types/nursing-home…

Format

pdf (quarterly 'Provider Rate Listing', text-extractable, plus billing rate letters)

Cadence

Quarterly

History

Archive page has quarterly listings and R-32 rate sheets back to SFY2019/2020 (listings found from Oct 2021 to the present): https://dch.georgia.gov/providers/provider-types/nursing-home…

Home identifier

Georgia Medicaid provider number (e.g. 00002164A) plus name. The listing also flags AHCA Bronze/Silver/Gold and Joint Commission. No NPI or CCN.

Verified October 11, 2026

Rate build-ups

Published

Yes

Where

https://dch.georgia.gov/providers/provider-types/nursing-home… (R-32 'Quarterly Case Mix Based Per Diem Rate Calculations', one page per home, in Medicaid provider-number order)

What they show

For each home: peer groups; percentile/multiplier; as-filed and audited cost by cost center; days; net per diems; base-period PDPM CMI; statewide standards; growth allowance; quarterly Medicaid PDPM CMI (facility and statewide); BIMS percent and add-on; nurse hours per day and staffing/quality percentage; efficiency add-on; provider fee; FRV; total quarterly rate; and bed-hold/leave rate.

Format

pdf (about 39 MB per quarter, 344 pages)

Example file

https://dch.georgia.gov/document/document/00002164a-park-plac…

Verified October 11, 2026

Recent changes

Verified October 11, 2026

Assisted living

Medicaid assisted living

Covered

yes

Program

Elderly and Disabled Waiver Program (EDWP), 1915(c), delivered as CCSP (Community Care Services Program) and SOURCE: 'Alternative Living Services' (ALS) in licensed personal care homes / assisted living. ALS is also offered in the Independent Care Waiver Program (ICWP ALS manual).

What is paid

Personal care and supervision services only. Room and board is paid by the member (typically from SSI) at a room-and-board rate set by the EDWP unit; the Medicaid payment is 'for personal care services, not for room and board.'

Rate

T1020 per diem: ALS Group Model $67.04/day; Family Model $68.97/day (effective 7/1/2024; earlier $55.28 from 8/11/2023).

Limits

Members must meet NF level of care. Enrollment is limited by waiver slots (a waitlist is not verified here).

Source

https://www.mmis.georgia.gov/portal/Portals/0/StaticContent/P…

Verified October 11, 2026

Sources

1. Part II Policies and Procedures for Nursing Facility Services, Chapter 1000 + Appendix D (Version Oct 1, 2026) · regulation
2. DCH Nursing Home Reimbursement Rates page (SFY2027) · agency page
3. Nursing Home Medicaid Rates effective 10/1/2026 (rate listing) · rate file
4. R-32 Quarterly Case Mix Based Per Diem Rate Calculations, eff. 10/1/2026 (all facilities) · rate file
5. Revised Billing Rate letter eff. 7/1/2026 (2024 RSMeans FRV update), 8/19/2026 · agency page
6. NHP Rate Sheet Archive · rate file
7. DCH PDPM page (transition timeline, shadow rates) · agency page
8. PDPM Implementation and Calculation presentation (11/6/2023, updated 12/4/2023) · agency page
9. Supplemental Quality Incentive Payments page · agency page
10. Public notice: Increase Supplemental Quality Incentive Payments (revised; eff. 9/13/2024) · agency page
11. Public notice: CMS LS measures for SFY2027 payments (9/30/2025) · agency page
12. Public notice: CMS LS measures CY2027 / SFY2028 (June 2026) · agency page
13. Nursing Home Provider Fee page + filing instructions / non-Medicaid fee report form · agency page
14. Provider Fee Report - Not in Medicaid, Not Exempt (Apr-Jun 2026, shows $17.10) · agency page
15. Nursing Home Supplemental Reimbursement (UPL) page + SFY2025 2nd interim payment memo · agency page
16. Fair Rental Value System page · agency page
17. EDWP (CCSP and SOURCE) General Services manual, Appendix rate table (Oct 2026) · regulation
18. EDWP (CCSP and SOURCE) Alternative Living Services manual (Oct 2026) · regulation
19. Personal needs allowance · secondary

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