Understanding Your Medicaid Rate

The most recent update to the nursing facility Medicaid rate included: 

1. Case-Mix update 
2. Fair Rental Value updates 

• • Cost per square foot 
  • Locations factors 
  • Historical cost index 
  • Items submitted on the Capital Data Survey (CDS)

To assist in assuring that your Medicaid rates are correct, Medicaid has posted a summary of the items submitted on the CDSs.  If you submitted items on a CDS, please click here and review the CDS Aging Schedule 2024 for completeness and accuracy for your facility/facilities.  

The Association also makes available a Medicaid Rate Calculator that details all components of the nursing facility Medicaid rate for any specified facility.  A hypothetical rate can also be estimated for any Medicaid case-mix and/or proposed facility renovation.  The file for the rates effective April 1, 2025 can be accessed in the member section of the Association website on the Reimbursement Resources page.  

Medicaid posts all of the Medicaid fee schedules at https://ncdhhs.servicenowservices.com/fee_schedules.