Freestanding Skilled Nursing Facilities and Subacute Units
Medi-Cal reimbursement rates for Freestanding Skilled Nursing Facilities Level-B (FS/NF-B) and Adult Freestanding Subacute Facilities Level-B (FSSA/NF-B) are updated each calendar year (CY) using a cost-based facility-specific methodology pursuant to Supplement 4
of Attachment 4.19-D of the California Medicaid State Plan.
Workforce Standards Program
Pursuant to Assembly Bill (AB) 186 (Chapter 42, Statutes of 2022) and State Plan Amendment (SPA) 24-0004, DHCS has established the Workforce Standards Program (WSP) beginning for CY 2024. Facilities that participate in the WSP will receive the enhanced per diem rate including the Workforce Rate Adjustment. Facilities that do not participate in the WSP will receive the basic per diem rate.
The CY 2024 and CY 2025 Rate Studies display both each facility's basic and enhanced per diem. DHCS is processing WSP opt-ins on a batch basis and updating CY 2024 and CY 2025 Rates on File to reflect the facility's participation in WSP. DHCS published the latest batch of updated Rates on File reflecting WSP opt-ins in July 2025 and further batches will be published soon. Facilities continue to receive the CY 2023 Rates on File until updated CY 2024 and CY 2025 Rates on File are published.
The opt-in period for CY 2026 is June 1, 2025 through August 1, 2025.
Please visit the
WSP website for additional information about the program.
CY 2026 Rates
CY 2026 Rates Studies Public Review Draft
The above documents contain preliminary modeling of FS/SNF-B and FSSA CY 2026 rates pursuant to approved SPA 24-0004 for public review. Please see the disclaimer included in each document. These drafts do not update the Medi-Cal rates on file and are not intended for payment purposes or any other use. Final CY 2026 rates may materially differ from this modeling based on changes on corrections to underlying data, changes necessary to obtain federal approval, and other changes deemed appropriate in DHCS's sole discretion. DHCS requests any comments or feedback no later than October 17, 2025. For any questions or comments, please email
AB1629@dhcs.ca.gov with the subject line “CY 2026 Rates Public Review Draft”.
CY 2025 Rates
CY 2025 Rates Studies
CY 2025 Rates Policy Letters
CY 2025 Published Rates on File
CY 2024 Rates
CY 2024 Rates Studies
The CY 2024 rate studies calculate both the basic and enhanced per diem rates for each facility.
Facilities that participate in the WSP will receive
the enhanced per diem rate including
the Workforce Rate Adjustment. Facilities that do not participate in the WSP will receive
the basic per diem rate.
CY 2024 Rates Policy Letters
CY 2024 Published Rates on File
CY 2023 Rates
CY 2023 Rate Studies
CY 2023 Rates
Policy Letters
CY 2023 Published
Rates on File
Managed Care
Plan Carve-In
Under CalAIM, Medi-Cal managed care plans (MCPs) will cover and coordinate Medi-Cal institutional Long-Term Care (LTC) in all counties in 2023 in a phased approach by facility type. Please see CalAIM Long-Term Care Carve-In Transition for additional information.
Please see the following All Plan Letters for requirements applying to MCPs:
Medi-Cal COVID-19 PHE Audits
Assembly Bill (AB) 81 (Chapter 13, Statutes of 2020) and Welfare and Institutions Code (WIC) section 14126.032 require DHCS to audit Freestanding Skilled Nursing Facilities Level-B (FS/NF-B) and Adult Freestanding Subacute Facilities (FSSA) costs and revenues that are associated with the COVID-19 Public Health Emergency (PHE) to determine whether a facility has adequately used increased Medi-Cal payments associated with the COVID-19 PHE to support the delivery of patient care, as defined in Section 14126.032(a).
Detailed information about the program, audit process, and reporting schedules can be found on the COVID-19 PHE Audits
website.
Contact Us
Please send your questions regarding any topic on this webpage to: AB1629@dhcs.ca.gov
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