This bulletin applies to NC Medicaid Managed Care and NC Medicaid Direct Skilled Nursing Facility providers.
Effective retroactively to Jan. 1, 2026, 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: | Date Posted | Continuing Care Retirement Communities and Tribal Facilities | Nursing Facility Total Annual Census Lower Tier (Large Census) | Nursing Facility Total Annual Census Upper Tier (Small Census) |
|---|---|---|---|---|
| N/A | Greater than 42,000 Patient Days | 0 to 42,000 Patient Days | ||
| New Rate: Jan. 1 to March 31, 2026 | Jan. 8, 2026 | N/A | $11.47 | $35.48 |
| Retroactively Adjusted Assessment Rate: Oct. 1 to Dec. 31, 2025 | Jan. 5, 2026 Adjusted after 10/1/2025 Rate Reductions Reversed | N/A | $10.73 | $33.20 |
| Rate Reduction Assessment Rate: Oct. 1 to Dec. 31, 2025 | Oct. 1, 2025 | N/A | $10.37 | $32.09 |
These adjustments have been implemented to ensure the assessment rate aligns with the Centers for Medicare & Medicaid Services (CMS)-previously approved SNF reimbursement methodology and the transition from RUG III to PDPM (Payment Driven Payment Model). The adjustment also reflects the Department’s commitment to benefiting SNF provider reimbursement by maintaining the maximization of the 6% assessment cap as allowed by CMS.
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 January 2026 is due Feb. 15, 2026.
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.
NOTE: Assessment rates were affected by the implementation and subsequent reversal of the Oct. 1, 2025, per diem rate reductions. Providers that paid the initially posted assessment rates for the October to December 2025 quarter will be addressed during the cost report reconciliation process. Assessment rate payments for the quarter Oct. 1, 2025, to Dec. 31, 2025, will be reconciled against the final retroactively adjusted assessment rates posted Jan. 5, 2026, applicable to the final per diem rates released for that same quarter. Providers do not have to take any action.
Contact
NC Medicaid Contact Center: 888-245-0179
Medicaid.ProviderReimbursement@dhhs.nc.gov