Medicaid Nursing Home Rates by State

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Nevada

Medicaid nursing facility payment · Statewide price · researched October 2026

Nevada’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

Statewide price

Case-mix level

Facility average

Classification

PDPM

Rate updates

Quarterly

Managed care (LTC)

Short stays only

Quality program

NF supplemental quality/MDS points

Paid outside the rate

Large

Bed hold

Leave only

Published rates

Rates and build‑ups

Assisted living

Covered

Personal needs allowance

$154 / month

Overview

• Nevada pays freestanding homes from statewide prices, not each home's own cost (price-based since 7/1/2003).
• The full rate = fair rental value (FRV) capital per diem + one statewide operating price (105% of the Medicaid-day-weighted median; $183.57 from 7/1/2026) + a direct health care price (110% of the case-mix-neutral median) scaled by the home's average Medicaid case-mix index.
• That full rate (median about $345-$360, day-weighted average $359.42 in July 2026) is then multiplied by a budget adjustment factor of only about 0.42-0.44, so the posted per diem is the full rate cut to fit the legislature's budget: a day-weighted average of $159.77 since 1/1/2024.
• July 2026 posted rates for the 49 in-state freestanding homes: median $157.56, range $146.05-$212.02.
• On top of the per diem, private homes get a large provider-tax-funded supplemental payment paid monthly as a lump sum (about $102 per Medicaid day at Alpine Nursing and Rehab in July 2026; about $89-$109 per Medicaid day statewide).
• Hospital-based homes in small counties are paid cost-based.

What matters in Nevada

• Posted rates are about 44% of the formula rate: one statewide budget factor scales every home to a $159.77 average.
• A provider-tax supplemental adds about $89-$109 per Medicaid day, roughly 55-70% on top of the per diem.
• Government-owned homes are excluded from both the provider tax and the supplemental, the reverse of most states.
• Homes below 65% Medicaid occupancy pay about 4x the provider tax: $106.40 versus $24.85 per non-Medicare day.
• Case mix is one PDPM (federal acuity system) average per home each quarter, fully phased in on 7/1/2026.
• Hospital bed hold is not paid, and Medicaid usually pays $0 of the Medicare day 21-100 coinsurance.

Frequently asked

How much of a case-mix increase reaches a Nevada home's posted per diem?

The case-mix-adjusted rate is multiplied by a statewide budget factor of about 0.42 to 0.48, so homes are paid roughly 42% to 48% of the formula rate.

Does Nevada pay the provider tax supplemental to county-owned nursing homes?

No. State and local government homes are excluded from both the provider tax and the supplemental, which adds about $89 to $109 per Medicaid day for other homes.

Does a Nevada home's Medicaid payer mix change its provider tax?

Yes. Homes at 65% or higher Medicaid occupancy pay $24.85 per non-Medicare day, and homes below 65% pay $106.40.

What does Nevada Medicaid pay on Medicare coinsurance days?

Lesser-of; because the per diem is far below Medicare's rate, Medicaid usually pays $0 of the coinsurance.

Does Nevada require a minimum share of spending on care?

Yes, optional for the state; homes spending under 94% of the direct care median may face recoupment of the difference.

How the rate is set

How the method got here

Verified October 11, 2026

Cost basis

Uses cost reports

Yes

Cost report

Medicare/Medicaid cost report (CMS-2540 with Medicaid sections), HIM-15/PRM-15 allowable cost rules; freestanding NFs file by the last day of the 3rd month after fiscal year end (4.19-D p.6; MSM 703.3). Separate FRV capital survey/submission for the fair rental value system.

Base year and rebasing

4.19-D p.5f: prices use each home's most recent audited or desk-reviewed cost report (review complete at least 3 months before July 1) and must be rebased no less often than every two years. In non-rebase years the medians are indexed forward. Observed statewide operating price on the posted consolidation sheets: $174.49 (Jul 2023), $182.51 (Jul 2024), $185.06 (Oct 2024), $193.58 (Jul 2025-Apr 2026), $183.57 (Jul 2026); the July 2026 drop suggests a rebase. The base year of the current rebase is not stated on the rate files.

Components

Component	Method	Notes
operating	Statewide price = 105% of the Medicaid-day-weighted median allowable cost (all allowable cost except direct care, capital and direct ancillaries). Same for every freestanding home: $183.57/day from 7/1/2026.	4.19-D p.5a. The Medicaid director may add to the operating price for new state/federal mandates not yet in base-year costs (p.5h).
direct health care	Statewide price = 110% of the Medicaid-day-weighted median case-mix-neutralized cost of RN, LPN and aide wages, benefits and agency staff. Each quarter the facility price = statewide price x (home's latest quarterly Medicaid CMI / the facility-wide CMI used when the price was set).	4.19-D p.5b. July 2026 facility direct prices range about $123-$255/day (Alpine $134.71, Sunset Ridge $254.66). From Oct 2024 to Apr 2026 this line was a blend of a PDPM-based and a RUG-III-based price (see case_mix).
capital (FRV)	Fair rental value: bed value ($73,000 at 7/1/2003, indexed annually by Marshall & Swift Class C), less 1.5%/yr depreciation (max age 40), times a 9% rental rate, divided by the greater of actual days or 92% occupancy.	4.19-D p.5c-5d.2. Renovations over $1,000/bed reported by May 1 are added and depreciated at 4%/yr. July 2026 FRV per diems run $18.56-$43.62.
budget adjustment factor	All three lines are summed into a 'Total Case Mix Adjusted Rate' and then multiplied by one statewide factor so projected payments equal the legislative appropriation (4.19-D p.5i).	Factor 0.4033 (Jul 2023), 0.4813 (Jul 2024), 0.4726 (Oct 2024), 0.4678 (Jan 2025), 0.4626 (Apr 2025), 0.4202 (Jul 2025), 0.4190 (Oct 2025), 0.4205 (Jan 2026), 0.4204 (Apr 2026); about 0.4445 in Jul 2026 (computed from posted rate / full rate; the factor column is blank on the July 2026 sheet).

Inflation

Nursing Home Services without capital (non-seasonally adjusted, Table 9 Percent Change in Medical Prices) as published by MEI; costs are moved from the base-year cost report midpoint to the rate-year midpoint; medians indexed forward in non-rebase years (4.19-D p.5e). In practice the budget adjustment factor, not inflation, sets the paid level.

Verified October 11, 2026

Case mix

System

PDPM

Applied at

Facility average

How it works

Each home gets one per diem per quarter built from the simple average PDPM case-mix index of its Medicaid residents on the first day of the quarter, so every Medicaid resident in the home is paid the same rate (4.19-D p.8; MSM 503.10).

Classification

PDPM-based facility CMI using CMS indices (MSM 503.10, eff. 9/30/2026), replacing RUG-III. The state plan text (4.19-D p.8, TN 10-009) still says 'CMS-mandated RUG and MDS systems'.

Applies to

Direct health care price only. Operating price and FRV are not case-mix adjusted, but the whole rate is then scaled by the budget adjustment factor.

Acuity measured from

Medicaid residents only for the payment CMI (a facility-wide all-resident CMI is also computed and is used to neutralize costs when the price is set). Picture date = first day of each calendar quarter, using each resident's most recent MDS; the rate effective April 1, 2026 used the 1/1/2026 picture (one-quarter lag). The rate sheet's case-mix worksheet shows total, Medicaid, Medicare and other resident counts and PDPM CMIs per home.

Updated

quarterly

Move to PDPM

Phased in over 8 quarters on the posted consolidation sheets: Oct 2024 12.5% PDPM / 87.5% RUG-III, Jan 2025 25/75, Apr 2025 37.5/62.5, Jul 2025 50/50, Oct 2025 62.5/37.5, Jan 2026 75/25, Apr 2026 87.5/12.5, and 100% PDPM from 7/1/2026 (the July 2026 sheet shows one PDPM direct price and no blend). Example Apr 2026 Alpine: PDPM direct price $142.22 x 87.5% + RUG-III price $158.28 x 12.5% = $144.23. No SPA for the transition was found on the state plan or SPA pages.

Verified October 11, 2026

Low-acuity residents

None found. Nevada pays one facility-average rate per home per quarter; there is no reduced or flat rate for low-acuity residents. Residents who do not meet NF level of care are not covered. Checked: 4.19-D (all pages), MSM Ch. 500 (eff. 9/30/2026) and the quarterly rate files Jul 2023-Jul 2026.

Verified October 11, 2026

Capital

Fair rental value (4.19-D p.5c-5d.2): $73,000/bed at 7/1/2003 indexed annually (Marshall & Swift Class C NF index), depreciation 1.5%/yr capped at age 40, rental rate 9%, divided by the greater of actual or 92%-occupancy days. Major renovations (>$1,000/bed, reported by May 1) are added at the next July 1 and depreciated at 4%/yr. July 2026 FRV per diems $18.56-$43.62. FRV is part of the total that is multiplied by the budget adjustment factor, so only about 44% of it is paid in the per diem.

Verified October 11, 2026

Budget adjustment factor

Central to Nevada. 4.19-D p.5i: computed rates are scaled proportionally so projected payments equal the legislative appropriation. The posted factor was 0.4033 in Jul 2023, 0.4813 in Jul 2024 and 0.4204 in Apr 2026; about 0.4445 in Jul 2026 (computed). Homes are paid only about 42-48% of the formula rate in the per diem. The plan fixes the target day-weighted average budget-neutral per diem at $159.77 from 1/1/2024 (TN 23-0023); the July 2026 sheet still lands on that average. The supplemental program's acuity half pays part of the gap back as a lump sum (see supplemental_payments).

Verified October 11, 2026

Add-ons and money outside the rate

Paid outside the posted rate

Level

large

Estimate

About 55-70% of base per diem payments. Derived: SFY2024 Q4 supplemental $28.07M vs base about $50.1M (313,830 Medicaid days x $159.77); Jul 2026 quarter posted supplemental $34.84M vs about $50.9M (318,559 days x $159.77). Per day, about $89-$109 on top of a ~$160 per diem.

Components

Provider-tax supplemental (acuity half + occupancy/MDS/quality half): about $111M/yr in SFY2024, $34.84M for the Jul-Sep 2026 quarter; new private-NF reserve supplemental $7.06M (SFY2026); BCCP QIP 3% add-on (size unknown).

Source

https://www.nevadamedicaid.nv.gov/siteassets/content/pgms/sr/…

Verified October 11, 2026

Payments by owner type

Applies

yes

Detail

Reverse of most states: government ownership loses the big add-on. Homes owned by the State or any political subdivision are exempt from the provider tax and ineligible for the provider-tax supplemental (worth roughly $90-$110 per Medicaid day to private homes). Hospital-based NFs on a government hospital campus in a county of 100,000 or less are paid Medicare cost principles (RCL, lesser of cost or charges), and the State Veterans Home is cost-settled. A March 2026 notice adds a further supplemental only for certain private NFs. Number of public/hospital-based homes not counted here.

Funding

Private supplemental funded by the provider tax plus federal match. No IGT-funded NF program found.

Source

https://www.nevadamedicaid.nv.gov/uploadedFiles/dhcfpnvgov/co…

Verified October 11, 2026

Quality program

Program

Quality and MDS-accuracy components of the Supplemental Payment to Free-Standing Nursing Facilities (provider-tax funded, since 10/1/2011). Separately, a Behaviorally Complex Care Program Quality Incentive Program (BCCP QIP) 3% annual add-on for BCCP-participating homes, first reporting period 7/1/2026-12/31/2026 (MSM 503.15, eff. 9/30/2026; SPA 26-0015 pending).

Funding

Provider tax (fee to increase the quality of nursing care) plus federal match; budget neutral within the tax-funded supplemental pool. BCCP QIP funded by budget enhancement E275 (83rd Legislative Session, 2025).

Size

Half of the supplemental pool (Pool A) is split 82% Medicaid occupancy, 9% MDS accuracy, 9% quality. With total supplemental payments of $28.07M in SFY2024 Q4 (about $112M/yr), the quality and MDS-accuracy shares are each about 4.5% of the total, roughly $5M/yr each. BCCP QIP size not published.

Paid as

Lump sum: part of the monthly supplemental payment (quarterly amount / 3; annual amount / 12 under SPA 25-0036). BCCP QIP: 3% annual add-on payment.

Measures

Measure	Source	Weight	How points are earned
MDS accuracy rate from Nevada Medicaid case-mix/MDS verification review	state (District Office RN reviews)	9% of Pool A	Modifier 0 below 70%, 1 at 70-79%, 3 at 80-89%, 5 at 90-100%, multiplied by Medicaid NF + LTC hospice days
Long-stay quality measures (state plan text: moderate-severe pain, high-risk pressure sores, UTI, excessive weight loss; the SFY2024 Q4 report actually scores pressure ulcers, falls with major injury, UTI, and increased need for ADL help)	MDS QM	9% of Pool A	One point per percentage point better than the Nevada average on each measure
BCCP QIP: antipsychotic/scheduled-medication review, 3+ hours behavioral health training for all direct care staff, repeat behavioral hospitalizations (no more than 5 residents with 2+), hospital/psychiatric MOU, reduce out-of-state placement	state (annual attestation report due Jan 31)	all-or-nothing	Must meet every metric for the year to get the 3% add-on

Scoring period

Supplemental: under SPA 25-0036 (eff. 10/1/2025) MDS-accuracy and quality use prior state fiscal year data; before that, a base quarter 6 months before payment. BCCP QIP: calendar year, report by Jan 31.

Payment formula

Points x unit value; unit value = component dollars / total points across eligible homes (pro-rata share).

Eligibility

In-state, Medicaid-enrolled freestanding homes not owned by the State or a political subdivision and without negotiated rates above the standard/special care rates. CMS Special Focus Facilities get no quality-component points.

Cadence

Supplemental computed quarterly through Sep 2025, then annually (SFY2026 remainder in nine monthly payments; twelve monthly payments thereafter with year-end reconciliation and a possible 13th payment).

Scores published

Yes, per-facility quality points, MDS accuracy, occupancy points and supplemental dollars are in the quarterly 'Provider Tax Report' PDFs, posted through SFY2024 Q4: https://www.nevadamedicaid.nv.gov/programs/supplemental-reimb…

Notes

The quality slice is small; most of the supplemental follows Medicaid occupancy and acuity.

Verified October 11, 2026

Provider tax

Charged

per non-Medicare day

Standard amount

Rate per non-Medicare patient day set so total collections equal 6% of statewide NF gross revenue (NRS 422.3775; MSM 703.2). SFY2025 Q2 rates: $24.85 (65%+ Medicaid occupancy) and $106.40 (below 65%). SFY2024: $24.76/$106.57 (Q1), $23.08/$103.10 (Q2), $21.91/$115.56 (Q3), $20.68/$101.43 (Q4).

Tiers

Who	Test	Amount
homes with 65% or higher Medicaid occupancy	medicaid_utilization	$24.85 per non-Medicare day (SFY2025 Q2)
homes below 65% Medicaid occupancy	medicaid_utilization	$106.40 per non-Medicare day (SFY2025 Q2)
homes owned or operated by the State of Nevada or a political subdivision	public	exempt (excluded from the statutory definition)

Lower for high-Medicaid homes

yes

Returned in the rate

Not in the per diem. Returned as the monthly Supplemental Payment to Free-Standing NFs: 6% of net patient revenue less 1% admin, plus federal match (e.g. $11.12M tax produced $28.07M of payments in SFY2024 Q4, about $89.45 per Medicaid day). Tax is an allowable cost (NRS 422.3775).

Source

https://www.nevadamedicaid.nv.gov/uploadedFiles/dhcfpnvgov/co…

Verified October 11, 2026

Provider tax notes

Fee to Increase the Quality of Nursing Care (NRS 422.3755-422.379; MSM 703.2). Charged per non-Medicare patient day at a rate set so the total equals 6% of statewide NF gross revenue. Homes with 65%+ Medicaid occupancy pay far less: $24.85/day vs $106.40/day for those below 65% (SFY2025 Q2). State and political-subdivision-owned homes are exempt by statute. All proceeds (less up to 1% admin) must raise NF Medicaid rates, which is done through the supplemental payment.

Verified October 11, 2026

Supplemental payments

(1) Supplemental Payment to Free-Standing Nursing Facilities (4.19-D p.10a-10f, since 10/1/2011). Pool = 6% of facilities' net patient revenue (the provider tax), less 1% for admin, matched with federal funds. Half (Pool B) is paid by acuity: it raises each home's effective pay toward its full (pre-budget-factor) rate. Half (Pool A) is paid 82% by Medicaid occupancy points (Medicaid share x Medicaid days), 9% by MDS accuracy, 9% by quality. Not available to State or political-subdivision-owned homes. Size: $28.07M in SFY2024 Q4; the posted 'FFS Only Quarterly Supplemental Payment' column sums to $27.78M (Apr 2026 quarter) and $34.84M (Jul 2026 quarter). SPA 25-0036 (submitted 12/31/2025, eff. 10/1/2025) moves it to an annual calculation with reconciliation. (2) New supplemental for 'certain private nursing facilities' funded from the surplus tax reserve (interest and penalties), effective 4/1/2026, estimated $7.06M for SFY2026 (public notice 3/27/2026). (3) Hospital-based NFs and the State Veterans Home are cost-settled rather than given supplemental payments.

Verified October 11, 2026

Other add-ons

(1) Behaviorally complex add-ons on top of the facility per diem: Tier I $111.23, Tier II $222.45, Tier III $326.26 (4.19-D p.9; unchanged on Jul 2026 file). (2) BCCP QIP 3% annual add-on for BCCP homes meeting all metrics (from the 7/1/2026 reporting period). (3) The 10/1/2017 change added 10% to the weighted average budget-neutral per diem used in the supplemental acuity math, plus a one-time payment for the quarter ending 12/31/2017 (4.19-D p.10d, 10g).

Verified October 11, 2026

Units paid separately

(1) Ventilator dependent (21+): facility FRV + $616.28 (eff. 1/1/2024), all-inclusive, e.g. $634.84-$659.90 in Jul 2026. (2) Pediatric Specialty Care Level I $790.58 and Level II $865.28 (under 21), all-inclusive, 4 homes. (3) Behaviorally complex care tiers (add-ons). (4) Negotiated facility-specific all-inclusive rates for unique high-cost needs; homes with negotiated rates above standard/special care rates lose supplemental eligibility. (5) Hospital-based NFs (sharing a campus with a government hospital in a county of 100,000 or less, or grandfathered before 7/1/1992): Medicare cost principles with a routine cost limit (RCL, $160.14 at 10/1/2001, indexed, rebased every other year) and lesser of cost or charges, interim paid at a cost-to-charge ratio and settled. (6) Nevada State Veterans Home: retrospective cost-based. (7) Out-of-state NFs: their home state's Medicaid rate rounded up to the next dollar, or negotiated. (8) Hospice in an NF: 95% of the NF daily rate for room and board (4.19-B item 15.d).

Verified October 11, 2026

Payment rules

Managed care for long-term care

Status

short_stay

Detail

MSM Ch. 3600 (eff. 1/1/2026), 3603.1.B.3 and 3603.4.E: MCOs must cover the first 180 calendar days of an NF admission, notify the State by day 175, and the member is disenrolled to FFS from day 181. Aged (65+) and disabled recipients and 1915(c) waiver enrollees are not in managed care at all, so most long-stay NF residents are FFS from day one. Statewide expansion to rural counties started 1/1/2026 (about 75,000 people) but did not add the aged/disabled populations.

Verified October 11, 2026

Who pays

fee_for_service (mostly). Seniors 65+, people with disabilities and HCBS waiver enrollees are excluded from Nevada's managed care program and stay in FFS. MCOs (Clark/Washoe, statewide from 1/1/2026) cover only the first 180 days of a nursing facility stay for members who are MCO-enrolled (mainly family/expansion adults); from day 181 the member is disenrolled and FFS pays.

Verified October 11, 2026

Included in the daily rate

Standard per diem includes nursing, oxygen administration, specimen collection, injections, routine supplies, reusable standard equipment (walkers, standard wheelchairs), laundry, hygiene items, activities and social work, maintenance therapy. Paid separately (not in standard LOC): prescription drugs, PT/OT/SLP therapy, physician services, laboratory/portable x-ray/diagnostics, emergency transport, custom or power wheelchairs, air-fluidized/low-air-loss beds, prosthetics/appliances. Ventilator and pediatric rates are all-inclusive (respiratory therapy, oxygen equipment, trach supplies). Hospital-based NFs may bill ancillaries in addition to room and board. Source: MSM 503 (eff. 9/30/2026).

Verified October 11, 2026

Bed hold

Hospital stays

Not paid. Attachment 4.19-C provides only for therapeutic leave, and MSM 503.5A says therapeutic leave does not include hospital ER visits or stays. No hospital bed-hold payment found.

Leave days

Paid at the home's per diem, up to 24 days per calendar year (no carryover). Requires a physician order and plan of care, and the same bed must be held.

Occupancy rule

None.

Notes

Billed with the therapeutic leave code in the billing guide. Leave days used at a prior NF in the same calendar year count against the 24.

Source

https://www.nevadamedicaid.nv.gov/uploadedFiles/dhcfpnvgov/co…

Verified October 11, 2026

Personal needs allowance

Per month

154

Effective

Updated in MAM F-100 (MTL 08/25, August 2025: 'Update Personal Needs Allowance Amount'); SB 45 (2023) ties the NF PNA to the residential group-care PNA starting 2024-01-01

Notes

DWSS Medical Assistance Manual F-100 Long Term Services: 'Deduct a $154 personal needs allowance (PNA) for each month of institutionalization.' The earlier $163 (compilation) was wrong; corrected to $154. SB 45 (2023) requires the NF PNA to be no less than the PNA for residents of residential facilities for groups from Jan. 1, 2024, so it moves with that amount. Residents with dependents at home (no community spouse) get an added PNA (current TANF need standard minus $459).

Confidence

confirmed

Source

https://www.dss.nv.gov/siteassets/dwss.nv.gov/content/medical…

Verified October 11, 2026

Medicare coinsurance days

Method

lesser_of

Rule

Attachment 4.19-B p.7 (QMBs): Medicaid pays Medicare deductibles and coinsurance only so far as the Medicare payment plus deductible and coinsurance do not exceed the Medicaid maximum allowable payment. MSM 503.6: patient liability (resident income) is subtracted from Medicaid's payment on all claims, including Medicare coinsurance days 21-100 and other third-party coinsurance claims. No NF-specific crossover rule or Medicare Advantage rule found.

Effect

Because the NF per diem (~$160) is far below Medicare's SNF PDPM rate, Medicaid usually pays $0 of the day 21-100 coinsurance, and any payment is further reduced by patient liability.

Source

https://www.nevadamedicaid.nv.gov/siteassets/content/resource…

Verified October 11, 2026

Required care spending

Applies

yes

Rule

Minimum direct care staffing requirement (4.19-D p.5g): if a home's direct care cost is below 94% of the direct care median, the Division may recoup from future payments 100% of the difference between the home's direct care rate and its actual cost. The quarterly consolidation sheet shows each home's 'PDPM Facility Specific Direct Health Care Floor' (about 85.45% of its direct price, i.e. 94%/110%; e.g. Alpine $115.11 on a $134.71 price in Jul 2026). Optional ('will have the option'); whether and how often it is enforced was not found.

Source

https://www.nevadamedicaid.nv.gov/uploadedFiles/dhcfpnvgov/co…

Verified October 11, 2026

Occupancy rules

Applies

yes

Rule

(1) FRV capital is divided by the greater of actual days or 92% occupancy, so homes below 92% get less capital per day. (2) Provider tax: homes below 65% Medicaid occupancy pay about 4x the per-day tax ($106.40 vs $24.85). (3) The Medicaid occupancy component (82% of Pool A, about 41% of the whole supplemental) pays Medicaid share x Medicaid days, so it rises with the square of Medicaid volume.

Source

https://www.nevadamedicaid.nv.gov/uploadedFiles/dhcfpnvgov/co…

Verified October 11, 2026

MDS accuracy penalties

(1) Nevada Medicaid District Office RNs review MDS coding at every freestanding NF at least annually (more often if the error rate is 40%+). If inaccurate coding raised payment, Medicaid may require a corrected MDS and recoup the overpayment (MSM 503.11). (2) The supplemental payment's MDS-accuracy component pays nothing to homes below 70% accuracy and scales 1/3/5 points for 70-79/80-89/90-100% (4.19-D p.10c).

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: each home's direct care price is reset from its latest Medicaid CMI picture (one quarter earlier), the budget adjustment factor is recalculated, and the statewide operating price and FRV change July 1. The supplemental lump sum was set quarterly until Sep 2025 and is now set annually.

Verified October 11, 2026

When rates change

Quarterly (first day of each calendar quarter); July 1 state fiscal year for price/FRV updates and budget changes; 1/1/2024 legislative increase (SPA 23-0023).

Verified October 11, 2026

Posted rates

Home-level rates published

Yes

Where

https://www.nevadamedicaid.nv.gov/Resources/Rates/NursingFaci…

Format

pdf (text-extractable): behaviorally complex tiers, in-state per diem + quarterly supplemental + vent/pediatric rates, out-of-state rates, consolidation (rate build) sheet, case mix worksheet

Cadence

Quarterly

History

October 2019 through July 2026 on the page. The 'Equivalent Daily Rate' (per diem + supplemental per day) is no longer calculated or posted.

Home identifier

NPI plus facility name

Verified October 11, 2026

Rate build-ups

Published

Yes

Where

Inside each quarterly rate PDF ('Consolidation' and 'Case Mix Worksheet' pages) at https://www.nevadamedicaid.nv.gov/Resources/Rates/NursingFaci…

What they show

Per home: prior-quarter actual Medicaid days, FRV per diem, operating statewide price, facility direct health care price (PDPM and RUG-III prices and the blend during the phase-in), total case-mix-adjusted (full) rate, projected payments, budget adjustment factor, final Medicaid rate, the direct health care floor (94% of median, CMI-adjusted) and vent rate; the case mix worksheet shows resident counts and PDPM CMI by payer on the picture date.

Format

pdf

Example file

https://www.nevadamedicaid.nv.gov/siteassets/content/resource…

Verified October 11, 2026

Recent changes

Verified October 11, 2026

Assisted living

Medicaid assisted living

Covered

yes

Program

1915(c) HCBS Waiver for the Frail Elderly (FE, MSM Ch. 2200): Augmented Personal Care (APC) in a licensed Residential Facility for Groups or Assisted Living Facility meeting HCBS settings rules. Fee schedules also list Provider Type 57 (Waiver for Elderly in Adult Residential Care) and Provider Type 59 (Assisted Living Waiver).

What is paid

Services only (homemaker, personal care, chore, companion, recreation, medication oversight, supervision). Room and board are not paid by Medicaid (MSM 2203); residents pay from income.

Rate

Per diem tiers as of 07/2026 fee schedules: PT 57 S5126 $78.00 (U2), $103.00 (U3), $124.50 (U4), eff. 1/1/2024; PT 59 T2031 $68.75 (U1), $103.13 (U2), $137.50 (U3), eff. 1/1/2024, plus $105.00 (no modifier) and $83.00 (U4) from 7/1/2021.

Limits

Legislatively capped waiver slots with an ADSD-managed waitlist by priority.

Source

https://www.nevadamedicaid.nv.gov/siteassets/content/resource…

Verified October 11, 2026

Sources

1. Nevada Medicaid Nursing Facility Rates page (quarterly rate PDFs Oct 2019-Jul 2026) · agency page
2. Nursing Facility Rates - July 1, 2026 (SFY27 Q1) · rate file
3. Nursing Facility Rates - April 1, 2026 (SFY26 Q4) · rate file
4. Nursing Facility Rates - October 2024 (first PDPM blend quarter) · rate file
5. Nursing Facility Rates - July 2023 · rate file
6. State Plan Attachment 4.19-D Payment for Long Term Nursing Facility Services · state plan
7. Complete Medicaid State Plan (compiled 10-09-26, 970 pages) · state plan
8. State Plan Attachment 4.19-C Payment for Reserved Beds · state plan
9. State Plan Attachment 4.19-B (QMB crossover p.7; hospice in NF 15.d) · state plan
10. SPA 25-0036 Nursing Facility Provider Tax Program (submitted 12/31/2025) · state plan
11. Public Notice: Supplemental Payment to Free-Standing Nursing Facilities SPA (3/27/2026) · agency page
12. SFY 2024 Q4 Provider Tax Report (Supplemental Payment to Free-Standing NFs) · rate file
13. Facility Medicaid Occupancy SFY 2025 Q2 (provider tax tier rates) · rate file
14. Nursing Facility Provider Tax Program page · agency page
15. Free-Standing Nursing Facilities Supplemental Payment page · agency page
16. NRS 422.3755-422.379 Fee to Increase Quality of Nursing Care · statute
17. MSM Chapter 500 Nursing Facilities (eff. 9/30/2026) · regulation
18. MSM Chapter 700 Rates and Supplemental Reimbursement (eff. 5/1/2026) · regulation
19. MSM Chapter 3600 Managed Care Organization (eff. 1/1/2026) · regulation
20. Statewide Managed Care Program page · agency page
21. MSM Chapter 2200 HCBS Waiver for the Frail Elderly (eff. 11/1/2024) · regulation
22. Provider Type 59 Assisted Living Waiver fee schedule (07/2026) · rate file
23. Provider Type 57 Waiver for Elderly in Adult Residential Care fee schedule (07/2026) · rate file
24. Personal needs allowance · secondary

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