Skilled nursing Medicaid rates in Indiana run above the national middle, and they come with an unusually busy calendar. Indiana Medicaid lists $309.47 a day for a nursing home stay, effective July 1, 2026. Indiana is not one of the 21 states in the daily-rate ranking, but its figure sits above the national median of $282.59.
What sets Indiana apart is how much moves around that per diem. In the three months from July to September 2026 alone, the state's long-term care rate-setting announcements covered supplemental payments, a quality program calculation for 2027, a capital allowance method and a new filing schedule. For an Indiana operator, the base rate is one line in a revenue picture with several moving parts.
The $309.47 figure is published without a billing code, as is usual for a facility per diem, and covers a full Medicaid resident day. The Indiana Medicaid rates page shows it with a link to its source document, drawn from the state's cumulative nursing facility rate listing.
Indiana's figure places it in the upper-middle of the national field. The leaders are New Mexico ($826.00), Colorado ($419.22), Rhode Island ($381.06), Washington ($373.84) and Kentucky ($365.78). Indiana's $309.47 trails that group but clears the median, and it is far above Arkansas's $70.00 at the bottom. For a facility weighing Indiana against neighboring markets, that places the state in a middle-to-upper band where the base rate alone is competitive.
Indiana sets nursing facility rates from components, each calculated on its own schedule. The 2026 record shows the main pieces:
Medians and statewide prices
The July 1, 2026 medians and statewide prices were posted on April 6, 2026. In a price-based system, these set benchmarks that facility costs are compared against, which limits how far any one facility's rate can rise or fall.
Resident acuity
A January 26, 2026 announcement covered changes to Medicaid rates and PDPM, effective July 1, 2026. The Patient Driven Payment Model classifies residents by clinical need, so the acuity of a facility's residents shapes its direct care payment.
Quality
A Quality Program Calculation for the July 1, 2026 rate was announced on March 26, 2026, and another for January 1, 2027 on September 30, 2026. Quality results therefore move the rate twice a year.
Capital
A Fair Rental Value Allowance Calculation pays for buildings on a standardized basis rather than actual debt or lease costs. A proposed update points to July 1, 2027.
Indiana's long-term care rate-setting announcements in 2026 fall into three groups.
Supplemental payments for SFY 2026.
- July 2, 2026: Supplemental Payment Calculations, Pathways only Payments.
- August 19, 2026: Supplemental Payment Calculations, Pathways only, Q1-Q3 SFY 2026.
- September 24, 2026: Supplemental Payment Calculation, Q4 SFY 2026 Interim Payment.
Rate components for 2027.
- September 30, 2026: Quality Program Calculation for the rate effective date of January 1, 2027.
- September 8, 2026: Fair Rental Value Allowance Calculation, a proposed change pointing to July 1, 2027.
Filing.
- September 22, 2026: Newly Qualifying Schedule Z, due September 30, 2026, tied to the January 1, 2027 rate.
Read together, these show a per diem built from components with supplemental payments layered on top. A facility that misses a filing such as Schedule Z, or does not follow the quality calculation, risks a rate that does not reflect its actual position.
Indiana pays supplemental amounts on an interim basis during the year and settles them afterward. On May 22, 2026, the state announced changes to both the SFY 2026 Q3 interim payment and the SFY 2025 final settlement payment.
That two-step structure has a practical consequence. Interim payments are provisional, and final settlement can raise or lower the total. Finance teams should:
- Record interim payments separately from per diem revenue.
- Reserve for settlement adjustments until the final figure is known.
- Reconcile each announcement against amounts actually received.
Indiana's managed-care rule for nursing facilities is that plans must pay at least the published rate. Our data counts 16 plans in Indiana, including Anthem, CareSource, Humana, Managed Health Services (MHS) and UnitedHealthcare, plus PACE organizations such as Franciscan Senior Health and Wellness and Heartland PACE.
For a facility, the rule works as a floor:
- No plan can pay below $309.47 for a day covered by that rate.
- Contracts can add to the floor, for example for higher-acuity or specialty residents.
- Supplemental payments sit alongside plan payment, as the Pathways-only calculations show.
Hospice follows the same floor rule in Indiana. The Indiana managed care page lists every plan and the rules for other service lines.
A floor rule changes what a plan negotiation is about. Price cannot fall below the published rate, so the conversation turns to what sits above it and how smoothly money moves.
Above-floor terms
Facilities with specialized units, strong quality results or capacity in short supply can ask for rates above the floor for residents whose care costs more. Those terms should be written into the contract, with the published rate named as the base.
Rate updates
Because the floor moves whenever the state rate changes, contracts should say that payment follows the current published rate automatically. That protects the facility at each January and July update.
Operations
Authorization timelines, claim deadlines and payment speed differ by plan. With price protected by the floor, these operational terms are where plans differ most for a facility.
Because the quality component is recalculated twice a year, quality is one of the few parts of the Indiana rate a facility can change within a single year. The measures used in the calculation reward consistent, documented care.
Practical steps include assigning an owner to each measure, reviewing results monthly rather than waiting for the state's calculation, and checking the data the facility submits for errors before each deadline. A small improvement sustained across a full measurement period can show up in the next rate, while a data error can cost a full six months of the quality component.
Indiana publishes Hospice Room and Board and Leave Day rates for nursing facilities. Room and board applies when a resident elects hospice: the hospice is paid for room and board and passes payment to the facility under their agreement. Leave day rates apply when a resident is temporarily away, such as in a hospital, while the bed is held.
Both are easy to miss in billing. Facilities should mark hospice and leave days separately in their census, keep hospice agreements current, and confirm that each day is billed under the right rate.
Indiana wages are below the US median for registered nurses and nursing assistants and slightly above it for licensed practical nurses, based on May 2025 federal occupational data.
| Role | Indiana | US median |
|---|---|---|
| Registered nurse | $40.14 | $46.90 |
| Licensed practical nurse | $31.60 | $30.96 |
| Nursing assistant (CNA) | $18.43 | $20.32 |
Nursing assistants deliver most hands-on care, and the Indiana CNA wage of $18.43 an hour is well below the national figure. The registered nurse gap is also large. Paired with an above-median daily rate, that gives Indiana facilities a relatively favorable cost-to-rate position compared with many states, before supplemental payments are counted.
The caution is that the per diem is rebuilt from components, and two of them change in 2027. If the quality calculation for January 1, 2027 or the capital allowance for July 1, 2027 moves against a facility, the favorable position narrows. Facilities with weaker quality results or older buildings should model those changes now rather than assume the July 2026 rate carries forward.
Two proposed notices affect who qualifies for Medicaid long-term care. One would require a Medicare application as a condition of Medicaid eligibility, effective July 1, 2027. Another changes the home and community-based services asset limit for couples, effective June 1, 2027.
Eligibility rules shape a nursing home's census and payer mix. Admissions and business office staff should learn the new rules before they take effect, so that applications are complete and residents do not face gaps in coverage.
For comparison, Kentucky, Indiana's neighbor to the south, ranks 5th at $365.78. Illinois, to the west, ranks below the national median. Michigan appears at $99.90 under code G9685, and Arkansas anchors the bottom at $70.00.
- Use $309.47 as the base and the plan floor, then add the supplemental and quality components that apply.
- Track the January 1, 2027 quality calculation and the July 1, 2027 capital allowance method.
- Meet filing deadlines such as Schedule Z.
- Reserve for supplemental settlements until final figures are announced.
All 28,364 current Indiana Medicaid rates, including the nursing facility rate listing, are available with a MedicaidRate plan.
Rates on this page are compiled from official state Medicaid publications for Indiana Medicaid, including the cumulative nursing facility rate listing, hospice room and board and leave day rates, and long-term care rate-setting announcements, and each rate links to its source document. Wages are May 2025 federal occupational medians. The national skilled nursing overview compares every state, and our methodology explains why only 21 of 44 states can be ranked.