Vermont
Vermont’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
- Quality Awards
- Paid outside the rate
- Small
- Bed hold
- Hospital and leave
- Published rates
- Rates only
- Assisted living
- Covered
- Personal needs allowance
- $79.93 / month
Overview
- Each home gets its own prospective per diem built from its own base-year cost report, inflated each year.
- The rate is the sum of Nursing Care, Resident Care, Indirect, Director of Nursing, Property and Related, and Ancillary pieces, plus any approved adjustments.
- Nursing Care is a cost per case-mix point (capped at the 95th percentile) times the home's average Medicaid case-mix score, reset every quarter.
- Resident Care is capped at 125% of the median and Indirect at 115% of the median (137% for special hospital-based homes); property and ancillaries pass through from the latest settled cost report.
What matters in Vermont
- Each home gets its own cost-based rate; the October 2026 median across 32 homes is $412.92/day, up from $374.96 in January 2025.
- Since July 2024 case mix uses PDPM nursing groups: one Medicaid average per home, reset every quarter.
- July 2024 loosened caps: nursing to the 95th percentile, resident care to median plus 25%, indirect to 115% of median.
- Non-nursing costs are spread over at least 80% occupancy, down from 90%; homes of 20 or fewer beds are exempt.
- Provider tax is a flat $4,919.53 per licensed bed per year, unchanged since 2011, with no Medicaid-share discount.
- Little money sits outside the posted rate: no UPL, IGT or managed care; quality awards total $125,000 at most.
Frequently asked
Does Vermont Medicaid still use RUG-IV case mix for nursing home rates?
No. From July 1, 2024 Vermont uses the PDPM nursing component (25 groups, its own weights), phased in over three quarters; rates have used PDPM scores alone since April 1, 2025.
How does Vermont Medicaid pay Medicare Part A coinsurance for dual-eligible nursing home residents?
In full. The state plan pays Part A coinsurance up to the Medicare rate, not limited to the Medicaid rate, so homes generally receive the $217/day 2026 coinsurance for days 21-100.
Does Vermont's nursing home bed tax depend on Medicaid use?
No. The assessment is a flat $4,919.53 per licensed bed per year, set in 2011, with no tiers, and no add-on returns it in the rate.
How much is paid outside the posted rate in Vermont?
Small: no UPL, IGT or directed payments; only quality awards, case-by-case relief and special-resident supplements.
Does Vermont require a minimum share of spending on care?
None, beyond spending quality awards on resident care.
How the rate is set
How the method got here
| Effective | From | To | Change | Headline | Source |
|---|---|---|---|---|---|
| 1991-07-01 | Pre-1991 Vermont nursing home payment method (not reviewed) | Prospective, facility-specific case-mix system with direct care, indirect and property cost categories and resident classes | Act 267 of 1989 (33 V.S.A. 905-907) set up Vermont's prospective case-mix cost-based system, still in use; the Division's rule took effect January 29, 1992. | Prospective case-mix cost-based system created | https://legislature.vermont.gov/statutes/section/33/009/00905 |
| 2024-07-01 | 2015 rule (as in MACPAC 2019): RUG-IV 48-group Medicaid case mix; Nursing capped at the 90th percentile; Resident Care and Indirect at median plus 5%; 90% minimum occupancy; all formulas in rule | PDPM nursing-component case mix (25 groups, phased in to 4/1/2025); Nursing capped at the 95th percentile; Resident Care at median plus 25%; Indirect at 115% of median; 80% target occupancy; formulas moved to the Provider Manual | The 7/1/2024 rule rewrite replaced RUG-IV with PDPM nursing groups and loosened every cost cap and the occupancy minimum. | PDPM case mix adopted and cost caps loosened | https://dvha.vermont.gov/sites/dvha/files/documents/NursingFa… |
Verified October 11, 2026
Cost basis
- Uses cost reports
Yes
- Cost report
Vermont uniform nursing facility cost report on Division of Rate Setting forms, filed annually by the end of the 5th month after fiscal year end (hospital-based homes within 5 days of their Medicare report). Medicare's Provider Reimbursement Manual (CMS-15) applies where the rule and manual are silent (HCAR 5.101.3.2-3.3, 5.101.4.1).
- Base year and rebasing
Statute (33 V.S.A. 905(c)) requires rebasing direct care at least every 3 years and other costs at least every 4 years. The Provider Manual (sec. 5.2) says all costs are rebased every 4 years (since 1/1/2007) and nursing costs every 2 years; property and ancillaries update yearly from the latest settled cost report. Rebase history: all costs 7/1/2019 on CY2017 (P&P 19-1); Nursing Care 7/1/2021 on CY2019 (P&P 21-1). The SFY2026 inflation workbook uses base year CY2023 for Nursing Care and CY2021 for Director of Nursing, Resident Care and Indirect, which implies a full rebase on 7/1/2023 (CY2021) and a Nursing Care rebase on 7/1/2025 (CY2023). On the 4-year/2-year cycle the next full rebase would be 7/1/2027 (no notice found).
- Components
Component Method Notes Nursing Care Base-year allowable nursing cost divided by standardized resident days (days x all-resident average case-mix score) = cost per case-mix point, capped at the 95th percentile of all homes (state homes excluded). Rate = cost per point x the home's quarterly Medicaid average case-mix score. Provider Manual 7.2.3-7.2.4, 7.8.3. Cap was the 90th percentile under the 2015 rule. Gets an extra 1 percentage point of inflation per 12 months from base-year midpoint to rate-year midpoint (Manual 5.4.1). Resident Care Base-year cost per day, limit = median plus 25%; rate = lesser of limit or cost. Food, utilities, activities, social services, medical director and consultants. Limit was median plus 5% under the 2015 rule (Manual 7.3). Indirect Base-year cost per day, limit = 115% of the median for private homes, 137% of the median for special hospital-based homes; rate = lesser of limit or cost. Administration, plant, housekeeping, laundry, dietary (non-food), insurance; management fees/home office capped at 5% of net allowable costs (HCAR 5.101.4.24). Private-home limit was median plus 5% under the 2015 rule (Manual 7.4). Director of Nursing Base-year allowable DON salary and fringe per resident day; no limit. Manual 7.5. Property and Related Allowable depreciation, interest, leases, property tax and equipment from the most recently settled cost report, per resident day; no limit. Updated at the first quarterly rate after settlement. Manual 7.7; large asset and change-of-ownership adjustments under HCAR 5.101.4.11. Ancillary From the most recently settled cost report: therapy (incl. IV) per Medicaid day, dialysis transport per Medicaid day, and medical supplies, OTC drugs, incontinence and personal care items per resident day. Manual 7.6. - Inflation
Health Care Cost Service (IHS Global Insight) Nursing Home Market Basket subcomponents (wages, benefits, utilities, food) and the New England CPI-U, weighted by Vermont homes' actual cost shares, set each June 1 for the July 1 rate year (Manual 5.4). SFY2026 factors (Q4 2024 forecast): Nursing Care 11.54% from the CY2023 base (9.04% plus 2.5 points extra); DON 23.6%, Resident Care 24.1%, Indirect 22.3% from the CY2021 base.
Verified October 11, 2026
Case mix
- System
PDPM
- Applied at
Facility average
- How it works
The Nursing Care piece is multiplied by one average case-mix score of the home's Medicaid-paid residents, certified at least quarterly by DAIL, so every Medicaid resident in a home gets the same rate (Provider Manual 7.2.2, 7.8.3).
- Classification
Vermont variant of PDPM using only the PDPM nursing component: 25 nursing groups with Vermont's own weights (ES3 3.84 high to PA1 0.62 low) (Provider Manual 5.1.2, 7.2.1).
- Applies to
Nursing Care component only (and any rate adjustment that pays nursing costs).
- Acuity measured from
Quarterly rates use the average score of residents whose room and board Medicaid pays. The base-year cost per point uses the all-resident average over the four quarters of the cost period. Residents on a special individual rate are excluded.
- Updated
quarterly (January 1, April 1, July 1, October 1)
- Move to PDPM
PDPM items required on OBRA assessments from 10/1/2020 to model a switch (DRS memo 8/20/2020). Moved from RUG-IV 48-group to the PDPM nursing component on 7/1/2024 with a phase-in: the last RUG-IV score weighted 75% (7/1/2024), 50% (10/1/2024) and 25% (1/1/2025) against the new score; full PDPM from 4/1/2025 (Provider Manual 7.8.4).
Verified October 11, 2026
Low-acuity residents
None. Vermont has no reduced or flat rate for low-acuity residents; the lowest PDPM nursing groups (PA1 0.62, PA2 0.67) only pull down the home's average score. Checked the 7/1/2024 HCAR 5.101 rule and the 2024 Provider Manual.
Verified October 11, 2026
Capital
Actual cost: Property and Related costs (depreciation, interest, leases, property tax, equipment) from the most recently settled cost report divided by resident days (at least 80% occupancy), no cap. Not fair rental value. Change-of-ownership basis step-ups and large asset purchases are handled by application (HCAR 5.101.4.7, 5.101.4.11).
Verified October 11, 2026
Budget adjustment factor
None for nursing homes. Rates are cost-based with inflation; no across-the-board factor or budget-neutrality cut appears in HCAR 5.101 or the Provider Manual. (DRS used a one-time inflation 'BAA' only for children's residential PNMI providers in SFY2023.)
Verified October 11, 2026
Add-ons and money outside the rate
Paid outside the posted rate
- Level
small
- Estimate
Well under 5% of base. Quality Awards are capped at $125,000 a year; behavior supplements, special rates and Extraordinary Financial Relief are case by case; the $10M 2025 stabilization fund was one-time and for all provider types. No UPL, IGT or directed payments found. Derived by elimination against 32 homes paid a median $412.92/day.
- Components
Quality Awards (up to $125,000/yr); behavior supplemental payments (amounts not published); Extraordinary Financial Relief (case by case, amounts not published); one-time Provider Stabilization Fund ($10M across all provider types, FY2026).
Verified October 11, 2026
Payments by owner type
- Applies
yes
- Detail
Narrow. State-owned or state-operated homes (one on the October 2026 list) are paid retrospectively on actual allowable cost with no caps, then settled, instead of the capped prospective rate (HCAR 5.101.9.4). Special hospital-based homes (one hospital corporation, common wall, one Medicare cost report) get an Indirect limit of 137% of the median versus 115% for other private homes. No IGT-funded payments for county or other public homes.
- Funding
State funds with federal match; no IGT arrangement.
Verified October 11, 2026
Quality program
- Active
Yes
- Program
Quality Awards Program (HCAR 5.101.9.5; Provider Manual 7.9)
- Funding
State Medicaid funds outside the per diem; no separate funding source stated.
- Size
$25,000 x number of qualifying homes, up to 5 homes ($125,000 a year maximum).
- Paid as
Annual lump-sum award, split among winners by Medicaid days.
- Measures
Measure Source Weight How points are earned Latest health survey survey pass/fail Score of 5 or less, nothing above 'D' scope and severity, and not a 'D' in each of Quality of Care, Quality of Life and Resident Rights Substantiated complaints state (DAIL) pass/fail None in the two most recent surveys on quality of care, quality of life or residents' rights Statewide quality improvement campaign state (DAIL) pass/fail Must participate Resident satisfaction survey state pass/fail Above the statewide average Fire safety survey survey pass/fail Score of 5 or less, nothing at 'E' or above Cost per day (tie-breaker) cost report tie-break only Lower allowable cost per day wins ties - Scoring period
Criteria applied to data through March 31 each year; awards presented before the end of the rate year (June 30).
- Payment formula
DAIL ranks eligible homes on quality; the top five get awards. Pool share = home's Medicaid days / total Medicaid days of the winners.
- Eligibility
Medicaid-participating homes meeting all basic criteria above.
- Cadence
annual
- Scores published
No public scorecards or award lists found.
- Notes
Homes must spend the award on quality for Medicaid residents after consulting the Resident Council, or DRS may recoup it. The DRS page states five homes receive awards each year; actual recent payments were not found.
Verified October 11, 2026
Provider tax
- Charged
per bed
- Standard amount
$4,919.53 per licensed bed per year, effective October 1, 2011 (was $4,509.57 from July 1, 2011); beds counted as licensed on June 30 of the prior fiscal year; late-payment charge up to $1,000.
- Lower for high-Medicaid homes
no
- Returned in the rate
No specific add-on or pass-through. The rule and Provider Manual are silent, so Medicare cost principles (CMS-15) would treat the assessment as an allowable cost inside the capped cost components; not confirmed.
Verified October 11, 2026
Provider tax notes
Nursing home assessment (33 V.S.A. 1954): $4,919.53 per licensed bed per year since October 1, 2011 (about $13.48 per bed-day), prorated for beds delicensed mid-year. Proceeds go to the General Fund (33 V.S.A. 1956). No add-on returns it; it is presumably recovered as an allowable cost through the cost-based components (not confirmed).
Verified October 11, 2026
Supplemental payments
Small. (1) Quality Awards up to $125,000 a year. (2) Extraordinary Financial Relief (HCAR 5.101.10): case-by-case rate adjustment or payment advance for homes in immediate danger of closing; Act 27 of 2025 required a report on reducing its use. (3) Monthly supplemental incentive payments (three DAIL-set levels) on top of the per diem for residents with severe behaviors (Manual 8.2). (4) One-time $10M Medicaid Provider Stabilization Fund (Act 27 of 2025) open to all provider types; $3.2M awarded to 8 applicants by 12/15/2025. No UPL, IGT or directed payments to nursing homes found.
Verified October 11, 2026
Other add-ons
None standing. Rate adjustments by application for change in services, change in law, receivership, efficiency measures, interest-rate changes and emergencies (HCAR 5.101.8), effective the first day of the next quarter; minimum 1% of rate (0.5% for asset purchases).
Verified October 11, 2026
Units paid separately
(1) Special individual rates for residents with unique physical conditions, set from the budgeted cost of the care plan, outside all limits; the resident is excluded from the home's case-mix average (Manual 8.1). (2) Residents with severe behaviors (approved by the Department of Mental Health): normal per diem plus one of three monthly supplemental payments (Manual 8.2). (3) Residents transferred from Department of Corrections custody: generally 150% of the home's rate (Manual 8.3). (4) State-owned homes: paid retrospectively on actual allowable cost, interim rate then settlement (HCAR 5.101.9.4). (5) Out-of-state homes: that state's Medicaid rate; prior-authorized out-of-state rehabilitation centers at the lowest of charges or a Region I Medicaid rate (HCAR 5.101.11). (6) New homes: budget-based rate for up to one year at the greater of estimated days or 80% occupancy. (7) Swing beds: average Vermont NF per diem of the prior calendar year, excluding supplemental payments (HCAR 5.101.13).
Verified October 11, 2026
Payment rules
Managed care for long-term care
- Status
no
- Detail
No private Medicaid managed care plan pays for nursing home care. Vermont operates Medicaid as a publicly administered statewide PIHP under the Global Commitment 1115 (AHS Medicaid Administration page); nursing facility care is a Choices for Care service under that 1115 (HCAR 7.102), paid by DVHA at the Division of Rate Setting rate on file. No day limits or carve-out apply.
Verified October 11, 2026
Who pays
fee_for_service in practice. Vermont runs all of Medicaid under the Global Commitment to Health 1115 demonstration through a publicly administered statewide prepaid inpatient health plan (PIHP; the state's own managed-care entity, DVHA). There are no private plans: DVHA pays nursing homes the per diem the Division of Rate Setting certifies, and Choices for Care (the long-term care program) is run by the state aging department (DAIL).
Verified October 11, 2026
Managed care rate floor
Not applicable: no private plans. DVHA (the state PIHP) pays the certified Division of Rate Setting rate (HCAR 7.102.4: nursing facility 'current rate on file').
Verified October 11, 2026
Included in the daily rate
Included: room and board, nursing, therapy by facility staff, special diets, incontinence care, laundry, personal hygiene supplies, all prescribed over-the-counter drugs, medical supplies, DME use, dialysis transport (HCAR 7603; Manual 7.6). Excluded: prescription drugs (billed by the pharmacy), Part B-type ancillaries (x-ray, lab, prosthetics, outpatient therapy) billed separately, emergency ambulance, personal comfort items.
Verified October 11, 2026
Bed hold
- Hospital stays
Paid at the full Medicaid per diem (less any patient share) for up to 6 successive days per hospitalization, only if the home would otherwise be full, the physician expects return within 10 days, and the resident went directly from the home to the hospital. Residents have a right to a held bed for up to 10 days.
- Leave days
Paid for home visits (overnight) of up to 24 days per calendar year, when in the plan of care.
- Occupancy rule
Hospital hold days are paid only if the home would otherwise be at its maximum licensed occupancy.
- Notes
Paid hold days count as resident days for cost reports and occupancy. Not paid to swing-bed facilities.
Verified October 11, 2026
Personal needs allowance
- Per month
79.93
- Effective
2024-01-01
- Notes
$159.85 for a couple. Was $47.66 in 2020 and $72.66 from 1/1/2021 to 12/31/2023. Not tied to a COLA by rule; DVHA posts the amount in its Eligibility Standards (HBEE 24.04(c)). HCBS/ERC participants keep a higher community maintenance allowance ($1,483/month in 2026).
Verified October 11, 2026
Medicare coinsurance days
- Method
full
- Rule
The state plan (Supplement 1 to Attachment 4.19-B) marks Part A coinsurance for QMBs, QMB-plus duals and other Medicaid recipients as 'MR': paid up to the full Medicare rate, not limited to the Medicaid rate. DVHA's billing manual (10/1/2026) says that after Medicare pays, DVHA pays deductibles and coinsurance on crossover claims (claims over $10,000 need review). The 2026 SNF coinsurance is $217.00/day (days 21-100). Medicare Advantage cost-sharing policy not found.
- Effect
For a dual-eligible on Medicare days 21-100 the home generally collects the full $217/day coinsurance from Vermont Medicaid (less any patient share), not a lesser-of $0.
Verified October 11, 2026
Required care spending
- Applies
no
- Rule
No rule requires homes to spend a share of the rate on care or staff. Only Quality Award money must be spent on care quality for Medicaid residents (with Resident Council input) or DRS may recoup it (Manual 7.9.2).
Verified October 11, 2026
Occupancy rules
- Applies
yes
- Rule
Per-day Resident Care, Indirect, Director of Nursing and Property costs are divided by the greater of actual paid days (including hold days) or days at 80% of licensed beds; Nursing Care and Ancillary are exempt. Waived for homes with 20 or fewer beds, closing homes and receiverships. Homes that cut licensed beds get the test recalculated on the new bed count. Was 90% before 7/1/2024.
Verified October 11, 2026
MDS accuracy penalties
None in the rate rules. DAIL's Division of Licensing and Protection audits assessments; DRS makes no retroactive rate changes from audits or appealed scores, since quarterly rates pick up corrected data going forward (HCAR 5.101.1.9(b)).
Verified October 11, 2026
Published rates and changes
How often rates change
- A home's rate changes
quarterly
- When
Every January 1, April 1, July 1 and October 1 the Nursing Care piece is reset for the home's Medicaid average case-mix score; property and ancillary updates from newly settled cost reports also take effect at the next quarterly rate. Annual inflation on July 1 (state fiscal year); rebases on July 1 (nursing every 2 years, all costs every 4). A resident's own assessment does not change the claim.
Verified October 11, 2026
When rates change
July 1 rate year (inflation, rebases); quarterly case-mix resets January 1, April 1, July 1, October 1. Rates are capped at the home's average customary private charge for a semi-private room (HCAR 5.101.5.3).
Verified October 11, 2026
Posted rates
- Home-level rates published
Yes
- Format
pdf (one-page list: facility name, Vermont Medicaid provider number, total per diem)
- Cadence
quarterly
- History
Only the current quarter is linked; earlier lists (e.g., October 2021, January 2025, January 2026) survive only on archive.org.
- Home identifier
Vermont Medicaid provider number (6-7 digits) and facility name; no CCN or NPI.
Verified October 11, 2026
Rate build-ups
- Published
No
- Where
Not posted. The DRS page posts the rule, Provider Manual, inflation workbook and quarterly rate list only.
Verified October 11, 2026
Recent changes
| Effective | Change | Headline | Direction | Size | Source |
|---|---|---|---|---|---|
| 2024-01-01 | The monthly personal needs allowance for nursing home residents rose from $72.66 to $79.93, so residents keep more income and pay slightly less patient share. | Personal needs allowance raised to $79.93 | structural | $72.66 -> $79.93/month | https://dvha.vermont.gov/sites/dvha/files/documents/Standards… |
| 2024-07-01 | Case mix moved from RUG-IV 48 groups to the PDPM nursing component (25 groups, Vermont weights), phased in 75/50/25% on the old score through 1/1/2025 and in full from 4/1/2025. | Case mix switched from RUG-IV to PDPM nursing | structural | https://dvha.vermont.gov/sites/dvha/files/documents/NursingFa… | |
| 2024-07-01 | Cost caps were loosened: Nursing Care from the 90th to the 95th percentile, Resident Care from median plus 5% to plus 25%, and private-home Indirect from median plus 5% to 115% of median. | Nursing, resident care and indirect caps raised | increase | Nursing 90th -> 95th pct; Resident Care median +5% -> +25%; Indirect median +5% -> +15% | https://dvha.vermont.gov/sites/dvha/files/documents/NursingFa… |
| 2024-07-01 | The minimum occupancy used to spread non-nursing costs per day fell from 90% to an 80% target, raising per-day rates for homes with lower occupancy. | Minimum occupancy standard cut to 80% | increase | 90% -> 80% | https://dvha.vermont.gov/sites/dvha/files/documents/NursingFa… |
| 2024-07-01 | HCAR 5.101 was rewritten so most rate formulas, caps, weights and the occupancy target now sit in the Provider Manual, which the Director issues and amends. | Rate formulas moved from rule into manual | structural | https://humanservices.vermont.gov/sites/ahsnew/files/document… | |
| 2025-07-01 | Nursing Care costs were rebased to calendar 2023 (inferred from the SFY2026 inflation workbook; no rebase notice was posted). | Nursing Care costs rebased to 2023 | increase | https://dvha.vermont.gov/sites/dvha/files/documents/SFY%2026%… | |
| 2025-07-01 | Act 27 of 2025 created a one-time $10M Medicaid Provider Stabilization Fund for providers of any type near insolvency and required a nursing home Extraordinary Financial Relief report. | One-time provider stabilization fund created | increase | $10M one-time, all provider types; $3.2M awarded by 12/15/2025 | https://legislature.vermont.gov/assets/Legislative-Reports/DV… |
Verified October 11, 2026
Assisted living
Medicaid assisted living
- Covered
yes
- Program
Enhanced Residential Care (ERC) under Choices for Care, part of the Global Commitment to Health 1115 (HCAR 7.102), for High and Highest Needs participants in licensed Level III residential care homes, assisted living residences and homes for the terminally ill. Level III homes and assisted living residences can also bill state plan Assistive Community Care Services (ACCS).
- What is paid
Services only: a bundled daily ERC tier rate for 24-hour supervision, nursing overview, personal care, medication management, activities, laundry and housekeeping. Choices for Care does not pay room and board; the resident pays it, with SSI state-supplement payment levels of $1,045.77/month (Level III assistive care) to $1,261.13/month (limited nursing care) in 2026.
- Rate
ERC tier rates are 'on file' with DAIL and were not found online. ACCS is a single statewide per diem: $89.93/day for 7/1/2026-6/30/2027 (DVHA standard deduction table).
- Limits
Highest Needs: no waitlist. High Needs: enrollment limited to appropriated funds, with a waitlist managed by regional teams (HCAR 7.102.6).
Verified October 11, 2026
Sources
- HCAR 5.101 Methods, Standards, and Principles for Establishing Medicaid Payment Rates for Long-Term Care Facilities (amended 7/1/2024) · regulation
- DRS Nursing Facility Provider Manual (2024-06-11) · regulation
- DVHA Division of Rate Setting - Nursing Home Rate Setting page · agency page
- Vermont Skilled Nursing Facility Medicaid Rates, Oct 1-Dec 31, 2026 · rate file
- Medicaid Quarterly Rate List page · agency page
- Rate summary January 2025 (archive.org copy; October 2021 list also used) · rate file
- SFY 2026 Incremental Inflation Factors (Q4 2024) · rate file
- DRS Practices and Procedures 19-1 (rebase all costs 7/1/2019) · agency page
- DRS Practices and Procedures 21-1 (Nursing Care rebase 7/1/2021) · agency page
- DRS memo: Update on MDS Requirements (8/20/2020) · agency page
- Prior DRS rule, effective 6 March 2015 (archive.org) · regulation
- Medicaid State Plan Attachment 4.19-D Addendum A (TN 13-016, 7/1/2013) · state plan
- 33 V.S.A. 905 Basis for determination of nursing home rates · statute
- 33 V.S.A. 1954 Nursing home assessment · statute
- 33 V.S.A. 1956 Proceeds from assessments · statute
- DVHA Medicaid Covered Services Rules 7100-7700 (10/2/2026): 7603 NF services, 7604 leave of absence · regulation
- State Plan Supplement 1 to Attachment 4.19-B: Medicare Part A/B deductible and coinsurance · state plan
- Vermont Medicaid General Billing and Forms Manual (2026-10-01) · agency page
- DVHA Eligibility Standards for Healthcare Programs (updated 10/1/2026) · agency page
- HBEE Part 4 Special Rules for Medicaid LTC (24.04 PNA) · regulation
- HCAR 7.102 Choices for Care · regulation
- Choices for Care High/Highest Needs Program Operations Manual (DAIL) · agency page
- AHS Medicaid Administration (publicly administered statewide PIHP) · agency page
- DVHA Annual Report 2025 & Budget Book SFY2027 · agency page
- DVHA legislative report: Medicaid Provider Stabilization Grant Program (12/15/2025) · agency page
- MACPAC 2019 Nursing Facility Payment Policies (baseline only) · secondary
Other states
Alabama · Alaska · Arizona · Arkansas · California · Colorado · Connecticut · Delaware · District of Columbia · Florida · Georgia · Hawaii · Idaho · Illinois · Indiana · Iowa · Kansas · Kentucky · Louisiana · Maine · Maryland · Massachusetts · Michigan · Minnesota · Mississippi · Missouri · Montana · Nebraska · Nevada · New Hampshire · New Jersey · New Mexico · New York · North Carolina · North Dakota · Ohio · Oklahoma · Oregon · Pennsylvania · Rhode Island · South Carolina · South Dakota · Tennessee · Texas · Utah · Virginia · Washington · West Virginia · Wisconsin · Wyoming