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Fiscal Year 2026 Rates for Nursing Facility Services
Effective date
Jul 1, 2025
Identified
Sep 29, 2026
Summary
Maryland Medical Assistance Program (Medicaid) has updated nursing facility reimbursement rates effective July 1, 2025, based on each facility's case mix index (CMI) as of March 31, 2025. Facilities must obtain updated rate letters from Myers & Stauffer, LC and implement new Medicare coinsurance calculations. The personal needs allowance for FY 2026 has been set at $106.00 per month per Medicaid participant.
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What to do
Action · 7 steps
01IMMEDIATE ACTION REQUIRED.
02Billing team must contact Myers & Stauffer, LC at (410) 356-9256 to obtain the facility's FY 2026 rate letter from the secure web portal if not already received.
03Verify the provider number on the rate letter matches your facility.
04Forward the rate letter to accounting/bookkeeping staff immediately to update billing system accounts and payment calculations.
05Before July 1, 2025: Access the updated Medicare Coinsurance Worksheet for service dates on or after July 1, 2025 from the Maryland Health Department Nursing Facility Providers page (Nursing Facility Document Library > Coinsurance Worksheets section) and integrate into billing workflows.
06Update all billing system configurations to reflect the new $106.00 monthly personal needs allowance for Medicaid participants effective FY 2026.
07Train billing and accounting staff on new rate calculations.
If missed: Failure to implement new rates will result in incorrect claim submissions and potential overpayments or underpayments to the facility.
Original notice
Fiscal Year 2026 Rates for Nursing Facility Services
health.maryland.gov · Always check the source before changing claims.
Related changes
See all Maryland Medicaid changes →Fiscal Year 2027 Rates for Nursing Facility ServicesHighEffective Jul 1, 2026 · Nursing HomeProposed Amendments to Nursing Facility Regulations - Fiscal Year 1999 Reimbursement ParametersMediumEffective Jul 1, 1998 · Nursing HomeFiscal Year 2006 Interim Rates for the Period 07/01/05-08/31/05MediumEffective Jul 1, 2005 · Nursing HomeJanuary 1, 2015 through March 31, 2015 Rates for Nursing Facility ServicesLowEffective Jan 1, 2015 · Provider TransmittalBrowse every Maryland Medicaid change in the policy list