Assessment Rate Adjustment for Skilled Nursing Facility Providers

Effective Oct. 1, 2025, NC Medicaid adjusted the provider assessment rates.

This bulletin applies to managed care and NC Medicaid Direct Skilled Nursing Facility providers.

Effective retroactively to Oct. 1, 2025, NC Medicaid adjusted the provider assessment rates per non-Medicare licensed bed day for Skilled Nursing Facility (SNF) providers, as reflected below. The rate for Continuing Care Retirement Communities and Tribal Facilities remain unchanged.

For Dates of Service
Beginning:
Continuing Care Retirement Communities and
Tribal Facilities
Nursing Facility Total
Annual Census
Nursing Facility Total
Annual Census
 N/AGreater than 42,000
Patient Days
0 to 42,000 
Patient 
Days
 
New Rate:
Oct. 1, 2025 to
June 30, 2026
 
N/A$10.37$32.09
Previous rate: 
July 1, 2025 to
June 30, 2026
 
N/A$9.99$30.92

The adjustment is implemented to ensure the assessment rate aligns with the Centers for Medicare & Medicaid Services (CMS)-approved SNF reimbursement methodology and recent rate reductions. The adjustment also reflects the change in Federal Medical Assistance Percentage (FMAP) that ended the enhanced FMAP the state received pursuant to Section 9814 of the American Rescue Plan Act of 2021 (Pub. L. 117-2).

SNF provider assessments are due within 15 calendar days of the last day of the reporting month. Payment at the new rate for the reporting month of October 2025 is due by Nov. 15, 2025.

Providers must complete and submit provider assessments timely in the Nursing Home Assessment (NHA) Portal to assure the assessment is calculated at the proper rate.

Contact

NC Medicaid Contact Center: 1-888-245-0179
Medicaid.ProviderReimbursement@dhhs.nc.gov 

Related Topics: