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Version 4 Updated 07/13/2026
7 | P a g e Average Cost to a Private Patient of Nursing Facility Services (§ 25.04(d)) This amount is used to calculate a penalty period for an individual in a nursing home or in the home and community- based waiver program.
Effective 10/1/25
10/1/24 – 9/30/25
$12,535.13 per month
$11,032.52 per month
$417.84 per day
$367.75 per day
SSI/AABD Payment Maximums (2700)
Effective 1/1/26 Effective 1/1/25 – 12/31/25 Living Arrangement
SSI Share
AABD Share
Total
SSI Share
AABD Share
Total Independent Living Individual Couple 994.00 1,491.00 55.68 105.80 1,049.68 1,596.80 967.00 1,450.00 55.68 105.80 1,022.68 1,555.80 Another’s Household Individual Couple 662.67 994.00 42.05 51.69 704.72 1,045.69 644.67 966.67 42.05 51.69 686.72 1,018.36
Residential Care Home w/ Assistive Community Care Level III
Individual Couple 994.00 1,491.00 51.77 103.54 1,045.77 1,594.54 943.00 1,450.00 51.77 96.77 994.77 1,553.34
Residential Care Home w/ Limited Nursing Care Level III
Individual Couple 994.00 1,491.00 267.13 603.69
1,261.13 2,094.69
967.00 1,450.00 267.13 603.69
1,234.13 2,053.69
Residential Care Home Level IV
Individual Couple
994.00 1,491.00 239.62 601.40
1,233.62 2,092.40
967.00 1,450.00 239.62 601.40
1,206.62 2,051.40
Custodial Care Family Home
Individual Couple
994.00 1,491.00
105.60 356.12
1,099.60 1,847.12
967.00 1,450.00
105.60 356.12
1072.60 1,806.12 Long-term Care
Individual Couple
30.00 60.00
49.93 99.85
79.93 159.85
30.00 60.00
49.93 99.85
79.93 159.85