As you may know, toward the end of each calendar year, our Division of Medicaid Services publishes an average per diem private pay nursing home reimbursement rate for the following year.  This per diem rate is primarily used to calculate a Medicaid applicant’s penalty period for an improper divestment of assets.  Effective January 1, 2026, the average per diem private pay nursing home rate will be $352.06.

Operations Memo 25-20 Published

The Wisconsin Department of Health Services has published Operations Memo 25-20, Private Pay Nursing Home and Group B Plus Waivers Rates.

This operations memo provides updates to the institutional cost of care values. These values include the daily average private pay nursing home rate used to determine a divestment penalty period. They also include the monthly average private pay nursing home rate and monthly rate for state centers for persons with developmental disabilities, which are used to calculate income limits for Home and Community-Based Waiver (HCBW) Group B Plus eligibility.

It is effective January 1, 2026.