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Nursing Home Rate Setting

The Methods of Implementation for Wisconsin Medicaid Nursing Home Payment Rates (the Methods) is our rate-setting methodology, as issued by the Department of Health Services, in accordance with Wisconsin statutes and federal guidelines. The Methods are used and updated annually by the Bureau of Rate Setting in the Division of Medicaid Services. The Methods defines cost reporting, allowable expenses, payment allowances and calculations, special rate adjustments, bed hold billing, and labor factors.

The Methods are used to set Medicaid daily payment rates for nursing facilities and a smaller number of intermediate care facilities for individuals with intellectual disabilities. It is also used as a reference for definitions and policy, for such topics as related party transactions, prudent buyer concept, self-funded Insurance, restricted use beds, and many others.

Last revised March 7, 2023