Medicaid Nursing Home Rates by State

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Mississippi

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

Mississippi’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

Transitioning to PDPM

Rate updates

Quarterly

Managed care (LTC)

No

Quality program

None

Paid outside the rate

Small

Bed hold

Hospital and leave

Published rates

Rates only

Assisted living

Covered

Personal needs allowance

$44 / month

Overview

• Mississippi sets a prospective rate for each home from that home's own cost report, rebased every January 1 on the cost report ending two calendar years earlier (CY2024 reports for 2026 rates).
• Per diem = (case-mix-neutral direct care base x the home's average case mix index) + care related + therapy (new for all homes from 1/1/2026) + administrative and operating + fair rental property payment + property tax and insurance + a 5.75% return on equity.
• Direct care and care related costs together are capped at 120% of the day-weighted median; administrative and operating at 109% of the class median, with an efficiency bonus for homes below it.
• The direct care line is re-multiplied each quarter by the home's average case mix from two quarters earlier, so the posted rate changes every quarter.
• The Q2 2026 rate file (4/1-6/30/2026) lists 168 homes: median $286.88/day, range $208.45-$349.24.

What matters in Mississippi

• Each home's rate is rebuilt every January from its own cost report two years back; Q2 2026 median is $286.88/day.
• Case mix is one facility-wide average over all residents, two quarters old, re-applied every quarter.
• Since January 2026 case mix uses a PDPM blend, with each home's 2026 change capped at plus or minus $5/day.
• MDS accuracy sanctions withhold 10x-30x the home's per diem when 25%+ of sampled assessments are wrong, doubling to 20x-60x on a failed follow-up review.
• Medicaid therapy (PT/OT/SLP) moved inside the daily rate on January 1, 2026; it was billed separately before.
• Nursing homes are fee-for-service only; MississippiCAN managed care does not cover them.
• No quality payment program exists, and supplemental payments were only about $3.5M in FY2024.

Frequently asked

Does Mississippi Medicaid adjust a nursing home's rate for each resident's acuity?

No. One facility-average case mix index, computed over all residents regardless of payer and lagged two quarters, multiplies the direct care line, and every Medicaid resident gets that home's single quarterly rate.

Are therapy services included in Mississippi's nursing home Medicaid rate?

Since January 1, 2026, yes. SPA 25-0015 added a therapy per diem built from each home's Medicaid-only PT, OT and SLP costs. Before that, therapy for small and large homes was billed separately by therapy providers.

How does Mississippi limit nursing home rate changes from the 2026 PDPM switch?

For calendar 2026, each home's direct care and care related rate under PDPM is compared with a RUG-IV calculation, and any gain or loss beyond $5 per day is removed by a pass-through adjustment.

How much is paid outside the posted rate in Mississippi?

Small: about $3.5M of UPL payments in FY2024, about 0.3% of nursing facility spending.

What does Mississippi Medicaid pay on Medicare coinsurance days?

Lesser-of: coinsurance is limited to the Medicaid per diem, so homes usually receive nothing.

Does Mississippi require a minimum share of spending on care?

No spending floor; rates follow each home's own reported costs, rebased every year.

How is the Mississippi nursing home provider tax charged?

Per occupied bed at the federal maximum, set by DOM; exact rate not found; returned only as an allowable administrative cost.

How the rate is set

How the method got here

Verified October 11, 2026

Cost basis

Uses cost reports

Yes

Cost report

Mississippi state-specific Long-Term Care Facility (LTCF) cost report (Excel 'MS LTCF Cost Report' Forms 1-19 plus schedules; Form 6 carries the cost lines, Form 14 the 80% occupancy adjustment). Due by the end of the 5th month after period end; late filing costs $50/day. Standard year ends: June 30 for state-owned, September 30 for county-owned, December 31 for all others. Myers and Stauffer runs rate setting for DOM.

Base year and rebasing

Rebased every year. Base rates take effect each January 1 and use the cost report for the period ending in the second calendar year before the rate year (CY2024 reports for 1/1/2026 rates; FYE 9/30/2024 for county homes). Costs are trended to the middle of the rate year with a mid-point factor (2.0 for a calendar-year report). Rates are adjusted quarterly for case mix only. 4.19-D Section 3-4.

Components

Component	Method	Notes
direct care + care related (combined ceiling)	Cost-based, ceiling at 120% of the day-weighted median. Direct care cost per day is divided by the home's cost-report-period average case mix to get a cost 'as if CMI 1.000', then care related cost is added and both are trended. The ceiling is 120% of the cost at the median patient day: one array for small and large homes together, a separate array for NFSDs. A home at or below the ceiling gets its own cost (no efficiency bonus); above it gets the ceiling. The base is then split back into direct care and care related by the home's own cost shares.	Direct care = RN/LPN/aide wages and benefits (excluding DON, ADON, MDS coordinator), respiratory therapists, feeding assistants, contract nursing, medical supplies, allowable drugs. Care related = DON/ADON/RAI coordinator, activities, social services, pharmacy, raw food, medical director, consultants. Only the direct care part is multiplied by the quarterly CMI.
therapy (PT/OT/SLP)	New for all homes for rates on or after 1/1/2026 (SPA 25-0015): Medicaid-only therapy charges x the home's cost-to-charge ratio / Medicaid days, trended. NFSDs keep their older therapy per diem (cost / total days, ceiling 105% of the median).	Before 2026, PT/OT/SLP for small and large homes was billed separately by therapy providers (fee for service). For 2026 rates DOM computed the therapy per diem from Medicaid paid claims; a new cost report schedule captures it going forward (PDPM Transition Memo 10/10/2025). Whether the ceiling applies to non-NFSD homes is not stated in the SPA pages seen.
administrative and operating	Cost-based, ceiling at 109% of the day-weighted median for each class (small 1-60 beds, large 61+ beds). Homes above the ceiling get the ceiling. Homes below it get trended cost + 75% of the gap between the ceiling and the greater of their cost or the median (efficiency incentive). Fixed costs are spread over at least 80% occupancy. NFSDs get their allowable cost.	Includes the nursing facility bed assessment (cost report line 4-43, Taxes & Licenses), management fees, home office costs, liability insurance and utilities.
property (fair rental) + property tax and insurance	Fair rental value by bed age plus pass-through of actual property tax and insurance per day; see capital.
return on equity	5.75% x average net working capital (non-property equity), capped at 2 months of allowable costs, divided by days at no less than 80% occupancy.	The 4.19-D example works out to $0.22/day.
PDPM transition pass-through (2026 only)	For rate periods 1/1/2026-12/31/2026, the direct care + care related rate under PDPM is compared with the same rate under RUG-IV for 1/1/2026. Any difference beyond +/-$5/day is removed (or added back) as a pass-through adjustment, so no home gains or loses more than $5/day from the PDPM switch in 2026.	4.19-D Section 3-10 (SPA 25-0015).

Inflation

A state-specific trend factor, recomputed each year. Each cost-report line item (Form 6) is weighted by its share of cost and multiplied by a market-basket economic indicator, giving separate factors for direct care, care related (combined into one DC/CR factor), therapy, and administrative/operating. Factors may be adjusted for known law changes or other forecastable cost factors. They are applied with a mid-point factor (months from cost report midpoint to rate year midpoint / 12; usually 2.0). Only homes with at least 80% occupancy and 12 months of operation are used. No trend factor applies to property, which is indexed by RS Means. 4.19-D Chapter 6.

Verified October 11, 2026

Case mix

System

Transitioning to PDPM

Applied at

Facility average

How it works

Each home gets one quarterly rate: its direct care base x its average case mix index over all residents two quarters earlier. Every Medicaid resident in the home is paid that same rate (4.19-D Section 3-4.B).

Classification

PDPM-based blend from 1/1/2026 (SPA 25-0015): each resident's CMI = 50% Nursing + 15% PT + 15% OT + 12% NTA + 8% SLP, using the FY2025 SNF PPS (CMS-1802-F) weights. In licensed Alzheimer's units, the nursing component uses Mississippi's higher Alzheimer's weights (e.g. PA1 0.794 vs 0.62; CDE2 2.266 vs 1.77; only for clinically complex and lower groups). Delinquent assessments (from day 93) default to BC1 at CMI 0.751. Before this: RUG-IV 48-group nursing-only (since 1/1/2015), with delinquent BC1 at 0.450.

Applies to

Direct care component only. Care related, therapy, administrative/operating, property and ROE are not case-mix adjusted.

Acuity measured from

All residents, regardless of payer ('the total case mix of the facility will be used in computing the per diem rate'). Case-mix-adjusted days / total days over the calendar quarter, counting all assessments in the quarter plus the last one from the prior quarter. Admission and reentry days count; discharge days do not. The quarter closes on the 5th day of the second month after quarter end; final rosters cannot be appealed. Quarterly rates use the final roster from the second preceding quarter (e.g. the Jul-Sep quarter sets the following January rate). The cost-report-period roster neutralizes direct care cost at rebasing. Bed-hold days: through 9/30/2025 a resident on leave counted at the lower of their CMI or 1.000; for ARDs on or after 10/1/2025 they keep their own CMI.

Updated

Quarterly (January 1, April 1, July 1, October 1).

Move to PDPM

SPA 25-0015 (submitted to CMS Dec 2025, effective 10/1/2025) and the DOM PDPM Transition Memo (10/10/2025). RUG-IV pays rates through 12/31/2025; the PDPM blend pays rate periods from 1/1/2026, using PDPM-grouped assessments back to the base cost-report period ending 2024. DOM issued informational 'shadow' PDPM rates for the July and October 2025 quarters. 2026 is a phase-in year with a +/-$5/day corridor on the direct care + care related change versus a RUG-IV calculation. Fiscal note: +$5.33M/yr total. Matched homes' posted rates moved a median +0.66% from Q4 2025 to Q1 2026 (152 homes).

Verified October 11, 2026

Low-acuity residents

None found. Mississippi does not pay a reduced or flat rate for low-acuity residents. Payment is a facility-average rate, so low-acuity residents only pull down the home's average CMI. The lowest PDPM nursing weights are PA1 0.62 and PA2 0.67, blended with therapy and NTA components. Related rules (not low-acuity carve-outs): (1) days after a missed or expired assessment (from day 93) count at the delinquent class BC1, CMI 0.751 under PDPM (0.450 under RUG-IV), lowering the home's average; (2) a person must score at least 50 on the PASRR Level I (or be found eligible on secondary or physician review) to qualify for nursing facility care at all (Part 207 Rule 2.7). Checked: SPA 25-0015 pages 88-98a, 4.19-D Sections 3-2 to 3-4 and 3-10, Part 207 Rules 2.5-2.10 (eff. 12/1/2025).

Verified October 11, 2026

Capital

Fair rental value (4.19-D Section 3-4.E). New bed value: $91,200 in 2015 (building, land and equipment), indexed each January 1 by the RS Means construction cost index for Jackson, MS. Licensed Alzheimer's unit beds get +37.20% of that value; NFSD beds 175%. Depreciation is 1.75%/yr of the facility's weighted average bed age; age is capped at 28.5714 years, so depreciation is capped at 50%. Renovations of $5,000 or more are converted to new-bed equivalents, which lowers the facility's age. Rental factor = 10-year Treasury average for the second preceding calendar year, floor 5.35%, cap 10%, plus a 2% risk premium (7.35% at the floor). Annual rental value / annualized patient days at no less than 80% occupancy. Actual property taxes and property insurance per day are added as a pass-through. No depreciation recapture on sales after 7/1/1993. 4.19-D example: a 120-bed 2010 building gets $17.64 FRV + $1.25 tax/insurance = $18.89/day.

Verified October 11, 2026

Budget adjustment factor

None found. There is no across-the-board cut or budget-neutrality factor in 4.19-D. Related rules: (1) the trend factor 'may be adjusted' for known law changes or other forecastable cost factors (Section 6-2.B.6); (2) the rate can never exceed the home's customary charges to the general public in aggregate, except for public homes charging nominal fees (Part 207 Rule 2.5.B.4); (3) the PDPM transition in 2026 is capped at +/-$5/day per home. Posted rates fell a median 5.3% (about -$15/day) from Q4 2024 to Q2 2025 across 156 matched homes. The posted files and plan text seen do not explain this (see open_questions).

Verified October 11, 2026

Add-ons and money outside the rate

Paid outside the posted rate

Level

small

Estimate

About 0.3% of base. MACPAC Exhibit 25 (CMS-64, FY2024) shows Mississippi supplemental payments to nursing facilities and ICF/IIDs of $3.5M against $1,352M in total payments. There is no quality pool, directed payment or managed care premium.

Components

UPL supplemental payments to non-state government (county/hospital) and state-owned NFs: about $3.5M combined with ICF/IID in FY2024. Cost settlement for state-owned NFs and PSNFs is not separately sized.

Source

https://www.macpac.gov/wp-content/uploads/2026/01/EXHIBIT-25.…

Verified October 11, 2026

Payments by owner type

Applies

yes

Detail

Non-state government-owned or operated NFs (county and county-hospital homes) can receive UPL supplemental payments that private homes cannot. State-owned NFs and PSNFs are paid 100% of allowable cost, settled to actual, plus UPL. County homes file on a September 30 year end. The gap is small statewide: about $3.5M/yr of supplemental payments in FY2024 (with ICF/IID). The number of qualifying homes was not found.

Funding

Not stated in 4.19-D. The statute allows a nursing facility assessment 'based on Medicaid utilization or other appropriate method' to fund the state share of a NF UPL program (43-13-117(A)(18)(b)(ii)). IGTs from public owners are likely but not confirmed. No lease or management arrangements for private operators were found.

Source

https://medicaid.ms.gov/wp-content/uploads/2025/12/MS-SPA-25-…

Verified October 11, 2026

Quality program

Active

No

Notes

No nursing facility quality payment exists. Attachment 4.19-D has no quality or value-based component. 2026 SB 2735 would have added 'The division may implement a quality or value-based component to the nursing facility payment system' to Miss. Code 43-13-117(A)(4). It passed the Senate 2/5/2026 and died in the House Medicaid Committee 3/3/2026. The only quality-linked money is federal CMP reinvestment grants, which are not rate payments. The 2019 MACPAC entry's 'efficiency' item is the 75% administrative/operating incentive, not quality.

Verified October 11, 2026

Provider tax

Charged

per bed

Standard amount

Statute: 'equal to the maximum rate allowed by federal law or regulation' (the 6% of net patient revenue safe harbor), per licensed and occupied bed, set by DOM. Levied per licensed and occupied bed; the cost report computes it as all patient days (any payer) x the bed tax rate. The current dollar rate was not found in any primary source reached.

Tiers

Who	Test	Amount
Homes operated by the U.S. Veterans Administration or other federal agencies, and State Veterans Affairs Board homes	public	exempt

Lower for high-Medicaid homes

no

Returned in the rate

Not as a separate add-on. It is an allowable cost (4.19-D 2-1.21, cost report line 4-43 'Taxes & Licenses') inside the administrative and operating component. It is reimbursed as part of trended cost, subject to the 109% of median A&O ceiling (with the 75% efficiency bonus below it), and lags two years through rebasing.

Source

https://billstatus.ls.state.ms.us/documents/2026/html/SB/2700…

Verified October 11, 2026

Provider tax notes

Nursing facility bed assessment, Miss. Code 43-13-145(1): levied 'in an amount set by the division, equal to the maximum rate allowed by federal law or regulation, for each licensed and occupied bed'. Federal VA and State Veterans Affairs Board homes are exempt. Homes pay it monthly based on occupancy. The cost report computes it as patient days x a 'Bed Tax Rate' (Form 14 line 4-43). It is an allowable cost (4.19-D Section 2-1.21), so it flows back through the administrative and operating component. The current $ per occupied bed day was not found.

Verified October 11, 2026

Supplemental payments

Upper payment limit (UPL) supplemental payments, 4.19-D Section 3-9. (1) Non-state government-owned or operated NFs (county and county-hospital homes) are paid 100% of the gap between an estimate of what Medicare would pay and Medicaid's per diem, times Medicaid days. The Medicare estimate is grouped under PDPM for state fiscal years ending on or after 6/30/2026; before that it used Medicare RUGs. (2) State government-owned NFs get 100% of their UPL gap, computed from cost report allowed amounts. State-owned homes are also paid 100% of allowable cost (cost settled). The statute (43-13-117(A)(18)(b)) allows a nursing facility UPL program, or a 42 CFR 438.6(c) payment, financed by a nursing facility assessment. Size: MACPAC Exhibit 25 shows Mississippi FY2024 supplemental payments to nursing facilities and ICF/IIDs of $3.5M out of $1,352M total (0.26%).

Verified October 11, 2026

Other add-ons

(1) Ventilator dependent care (VDC) add-on on top of the standard per diem, for approved VDC residents in small and large homes (not NFSDs or out-of-state homes). It was $178.34/day from 1/1/2015 and rose to $378/day effective 2/1/2026 under SPA 26-0001 (+$105,871/yr). A provider comment says only one VDC unit operates, with a reported cost of $689/day. Homes need a VDC addendum and must meet a staffing ratio of at least 1 RN per 10 vent residents, outside state minimum staffing (Part 207 Rule 2.15). (2) Alzheimer's units: higher nursing CMI weights for licensed Alzheimer's/dementia unit residents (MDS Section S), and fair rental bed value +37.20%. (3) 2026 PDPM transition pass-through (+/-$5 corridor). (4) No COVID-era add-on remains: the $13/day LTC add-on (SPA 21-0005) ran 1/1/2021-6/30/2021 only.

Verified October 11, 2026

Units paid separately

(1) Nursing Facilities for the Severely Disabled (NFSD): a separate class. Residents need spinal cord injury, closed head injury, long-term vent dependency or similar, plus a qualifying RUG-IV group. NFSDs have their own 120% DC/CR ceiling array, a therapy per diem (105% of median ceiling), A&O at allowable cost, and a new bed value at 175%. (2) State-owned NFs and, from SPA 25-0015, state-owned Pediatric Skilled Nursing Facilities (PSNF, ages 0-20, medically or technology dependent): paid 100% of allowable cost subject to the Medicare upper limit, settled to actual cost after the cost report. (3) New homes: paid the class maximum (DC/CR ceiling at CMI 1.000 + A&O ceiling + gross rental) until the first 3-6 month cost report, then adjusted back to certification. (4) Changes of ownership: the new owner keeps the old owner's cost-based rate until its own report is used. (5) Out-of-state NFs: lesser of their home-state Medicaid rate or Mississippi's maximum, or negotiated. (6) Hospital swing beds: the statewide average NF rate from the prior calendar year. (7) ICF/IID and PRTF have separate cost-based methods.

Verified October 11, 2026

Payment rules

Managed care for long-term care

Status

no

Detail

DOM's 2026 Managed Care Quality Strategy says LTSS (HCBS waivers and services in institutional facilities) are 'carved out of managed care in Mississippi'. MississippiCAN MCOs only identify members who need LTSS and refer them to fee-for-service LTSS programs. Nursing homes are paid fee-for-service on DOM's posted per diem.

Verified October 11, 2026

Who pays

fee_for_service. Nursing facility care, like all long-term services and supports, is carved out of MississippiCAN managed care and paid by the Division of Medicaid (DOM) directly.

Verified October 11, 2026

Managed care rate floor

Not applicable. Nursing facility care is carved out of MississippiCAN, so there is no MCO rate floor for nursing homes. DOM contracts with Medicare D-SNPs only for care coordination reporting (MIPPA contracts), not for Medicaid nursing home payment. Source: https://medicaid.ms.gov/wp-content/uploads/2026/01/2026-MS-Ma…

Verified October 11, 2026

Included in the daily rate

Included (Part 207 Rule 2.6.C): room, nursing, respiratory therapy, dietary and supplements, activities, social services, laundry, OTC drugs, legend drugs not covered elsewhere, medical supplies (enteral, diabetic, incontinence, oxygen administration supplies), most DME, personal hygiene items, medically needed private rooms, ventilators, and non-emergency transportation (the home must arrange and pay; it cannot use the NET broker). From 1/1/2026, PT/OT/SLP for Medicaid-only residents are included in the per diem through the new therapy component (4.19-D 2-1.18, SPA 25-0015). Paid separately to other providers: lab, X-ray, drugs covered by the Medicaid drug program/Medicare/VA, ostomy supplies, CPAP/BiPAP, custom wheelchairs, emergency transport. The Part 207 Rule 2.6.D.4 text dated 12/1/2025 still lists PT/OT/SLP as billed separately, so it conflicts with the 2026 SPA.

Verified October 11, 2026

Bed hold

Hospital stays

Paid at the full per diem for up to 15 consecutive days per inpatient acute stay (including geriatric psych units), with no annual limit. A new 15-day period starts only after the resident is back for 24 hours. Not paid for observation stays, or when the resident moves to a Medicare SNF or swing bed after the hospital.

Leave days

Paid at the full per diem: up to 15 consecutive days per absence and 42 days per state fiscal year (July-June), plus 6 holiday days (Thanksgiving and Christmas and the day before and after each). Requires physician approval and the plan of care. An absence counts as leave when it is 8+ hours or at midnight, excluding dialysis, chemo, therapy and frequent treatments.

Occupancy rule

None.

Notes

A home that bills leave days must hold the bed and readmit the resident. Leave must be entered in the case-mix portal and is reconciled in case-mix reviews. 2026 SB 2735 would have cut home leave to 21 days/yr; it died 3/3/2026.

Source

https://medicaid.ms.gov/wp-content/uploads/2025/12/Title-23-P…

Verified October 11, 2026

Personal needs allowance

Per month

44

Effective

In effect per Miss. Admin. Code Title 23 Part 105 Rule 8.3 (admin code compiled eff. 10/1/2025); start date not found

Notes

Basic PNA $44/month. Residents in work therapy or paid activity get a PNA on earnings equal to half the SSI federal benefit rate less $44, plus $44 against other income. Veterans or dependents with the $90 reduced VA pension keep $90. Not indexed.

Source

https://medicaid.ms.gov/wp-content/uploads/2025/10/Entire-Adm…

Verified October 11, 2026

Medicare coinsurance days

Method

lesser_of

Rule

Attachment 4.19-B Item 1 (TN 2010-001): Part A deductible and coinsurance for nursing facility, hospice and home health are 'limited to State plan rates' for duals, QMB-plus and QMBs; the Part A hospital deductible/coinsurance and Part B are paid in full. Part 207 Rule 2.4: the state is not required to pay cost sharing beyond what Medicaid would have paid, and Medicare plus Medicaid is payment in full. Medicare Advantage cost-sharing treatment was not found.

Effect

Medicaid pays day 21-100 coinsurance only up to the home's Medicaid per diem minus Medicare's payment. With Medicare SNF rates well above Mississippi's roughly $287 median, the home usually receives $0 of the coinsurance.

Source

https://medicaid.ms.gov/wp-content/uploads/2026/02/StatePlanE…

Verified October 11, 2026

Required care spending

Applies

no

Rule

No spending floor or recoupment rule. Because rates are rebuilt from each home's own costs every year, under-spending lowers the next rate two years later. The direct care + care related base is the lower of cost or the 120% ceiling, with no bonus for spending below it. Below-ceiling administrative cost does earn 75% of the gap to the ceiling.

Source

https://medicaid.ms.gov/wp-content/uploads/2026/02/StatePlanE…

Verified October 11, 2026

Occupancy rules

Applies

yes

Rule

80% minimum occupancy (4.19-D 3-6): fixed administrative and operating costs, fixed care related costs, fair rental property, and return on equity are divided by the greater of actual days or 80% occupancy of Medicaid-certified beds. Bed-hold days count as occupied. Not applied to direct care, therapy, or variable A&O/care related costs (Form 14 splits fixed vs variable). Homes below 80% occupancy are also excluded from the trend factor sample.

Source

https://medicaid.ms.gov/wp-content/uploads/2026/02/StatePlanE…

Verified October 11, 2026

MDS accuracy penalties

Yes. RN case-mix reviews sample at least 10% of beds, covering all payers. Classification errors change the home's CMI, and the sample is expanded if 25% or more of sampled assessments have errors that change the class (4.19-D 3-2.C). DOM's 'Sanction Policy for Inaccurate Case Mix Assessments' (posted 2019) adds money penalties. When 25% or more of the sample is in error, the home pays 10x its per diem (25-34% errors), 15x (35-44%), 20x (45-54%), 25x (55-64%) or 30x (65%+), withheld from the next payment. If a follow-up review still finds 25% or more errors, the multiples double (20x to 60x). Sanctions are non-allowable costs. Delinquent assessments default to BC1 (CMI 0.751 under PDPM). Reviews also reconcile temporary leave records against billing (Part 207 Rule 2.10.D).

Verified October 11, 2026

Published rates and changes

How often rates change

A home's rate changes

quarterly

When

Base components are rebased each January 1. The direct care line is re-multiplied by the home's facility-average CMI each January 1, April 1, July 1 and October 1, using the final roster from two quarters earlier. Bed-count changes enter the next quarter. Rates do not change with individual resident assessments.

Verified October 11, 2026

When rates change

Calendar-year base rates effective January 1, with quarterly case-mix updates April 1, July 1 and October 1. Legislative and SPA changes can take effect mid-year (e.g. VDC $378 on 2/1/2026).

Verified October 11, 2026

Posted rates

Home-level rates published

Yes

Where

https://medicaid.ms.gov/providers/fee-schedules-and-rates/ (Long Term Care / 'Nursing Home (NH) Rate Calculation' PDFs, e.g. https://medicaid.ms.gov/wp-content/uploads/2026/04/Q2-2026-NF…). medicaid.ms.gov reset connections from this network in Oct 2026; files were read from Wayback Machine captures.

Format

pdf (one page per alphabet block: provider name + total quarterly per diem; text-extractable)

Cadence

Quarterly. Q2 2026 (4/1-6/30/2026) was the latest file captured; no Q3 2026 file was found.

History

Files seen back to Q2-Q3 2022 (re-posted 2024) and every quarter 2024-Q2 2026. Rates paid in CY2021 were posted per the 2021 COVID SPA.

Home identifier

Facility name only: no Medicaid provider number, NPI or CCN. Names change with ownership and spelling, so matching across quarters needs fuzzy matching.

Verified October 11, 2026

Rate build-ups

Published

No

Where

None public. The posted file is titled 'Rate Calculation' but shows only the total per diem. Per-home component build-ups, ceilings, trend factors and CMI rosters go to each provider (roster reports via the case-mix portal; rate questions to Myers and Stauffer at MississippiLTC@mslc.com). Cost report forms are posted as xlsx.

What they show

Public file: provider name and the total quarterly per diem only. Not shown: direct care/care related/therapy/A&O/property/ROE split, ceilings, medians, trend factors, CMI, or the PDPM pass-through.

Format

pdf

Example file

https://medicaid.ms.gov/wp-content/uploads/2026/04/Q2-2026-NF…

Verified October 11, 2026

Recent changes

Verified October 11, 2026

Assisted living

Medicaid assisted living

Covered

yes

Program

HCBS Assisted Living (AL) Waiver, a 1915(c) waiver run by DOM (Part 208 Chapter 3) for people 21+ who meet nursing facility level of care and are SSI or institutional-eligible (income trust if over the limit). Carved out of MississippiCAN.

What is paid

Services only: personal care, homemaker, attendant care, medication oversight, therapeutic/social/recreational programming, intermittent skilled nursing (8+ hours a day) and case management, in a licensed Personal Care Home - Assisted Living. 'The Division of Medicaid does not reimburse for room and board' (Rule 3.10.B); transportation is included.

Rate

Assisted Living Services (T1020 U4) $82.78 per diem effective 1/1/2026 (DOM HCBS rate change bulletin, Dec 2025). Milliman's SFY2027 rate model proposed $84.99/day (draft 3/31/2025; adoption pending legislative action). TBI residential: $494.09/day.

Limits

Enrollment slot cap and waitlist not confirmed. Providers must be licensed PCH-AL facilities that pass a DOM inspection, and settings must meet the HCBS settings rule.

Source

https://medicaid.ms.gov/wp-content/uploads/2025/12/HCBS-Rate-…

Verified October 11, 2026

Sources

1. MS SPA 25-0015 PDPM and state-owned PSNF, Attachment 4.19-C/4.19-D clean+strike (submitted Dec 2025; Wayback capture 2025-12-30) · state plan
2. MS SPA 25-0015 public notice (9/30/2025) with fiscal impact · agency page
3. DOM memo: Transition from RUG-IV to PDPM (10/10/2025) · agency page
4. Mississippi Medicaid State Plan, entire document (eff. 10/1/2025, updated 2/13/2026) incl. Attachment 4.19-D and 4.19-B Item 1 · state plan
5. MS SPA 26-0001 Ventilator Dependent Care public notice (1/26/2026) and public comments · agency page
6. Miss. Admin. Code Title 23 Part 207 Institutional LTC (eff. 12/1/2025) · regulation
7. Miss. Admin. Code Title 23, entire Medicaid administrative code (eff. 10/1/2025): Part 105 Rule 8.3 PNA; Part 208 Ch. 3 Assisted Living Waiver · regulation
8. DOM Nursing Home (NH) Rate Calculation, Q2 2026 (4/1-6/30/2026) · rate file
9. DOM NH rate files Q1 2024-Q1 2026 (Q4 2024, Q2 2025, Q3 2025, Q4 2025, Q1 2026 used for comparisons) · rate file
10. Sanction Policy for Inaccurate Case Mix Assessments (DOM, posted 2019) · agency page
11. MS LTCF Cost Report forms, 2024 year ends (Form 14 bed tax line 4-43) · agency page
12. 2026 SB 2735 as passed Senate (shows current Miss. Code 43-13-117(A)(4), (A)(18) and 43-13-145 text; bill died 3/3/2026) · statute
13. 2026 SB 2735 bill history (died in House committee 3/3/2026) · statute
14. DOM 2026 Managed Care Quality Strategy (LTSS carved out of managed care) · agency page
15. DOM HCBS Rate Changes bulletin, December 2025 (AL Waiver T1020 U4 $82.78 eff. 1/1/2026) · agency page
16. Milliman, SFY2027 HCBS Payment Rate Update Analysis (draft 3/31/2025) · agency page
17. MACPAC MACStats Exhibit 25: Medicaid supplemental payments to non-hospital providers by state, FY2024 · secondary
18. MACPAC 2019 nursing facility payment policy compendium (baseline only) · secondary

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