Increased Nursing Facility Rate for Medicaid Managed Care Nursing Facility Short Term Stays Reimbursed by Managed Care Health Plans

To better support providers and members, NC Medicaid is increasing the nursing facility rate for Medicaid-only managed care members during nursing facility stays.    

Retroactive to January 1, 2023, NC Medicaid is requiring health plans to pay nursing facilities no less than 95% of the facilities’ adjusted Medicare rate for the first 20 days of the nursing facility stay, and then pay no less than 80% of the facilities’ adjusted Medicare rate for the remainder of the nursing facility stay covered under managed care.    

For additional information, read the entire announcement by clicking here.