Skilled nursing Medicaid rates in Alaska are the highest published figures in our national data: Alaska Medicaid lists $1,100.69 a day for a nursing home stay, effective January 1, 2026. Alaska is not one of the 21 states in the daily-rate ranking, so it carries no rank or percentage gap, but the number speaks for itself next to a national median of $282.59 and a top ranked value of $826.00 in New Mexico.
For an operator, the takeaway is that Alaska is a cost-based, high-cost market, and the per diem reflects it. The rest of this page explains how that rate sits against wages, how often Alaska revisits it, and why there is no managed-care layer to negotiate.
The Alaska Medicaid nursing home rate per day
Alaska's nursing facility figure is published without a billing code, as is common for facility per diems. It is a daily amount paid for each Medicaid resident day, and it is meant to cover the full stay: nursing, personal care, dietary, housekeeping, activities, administration and the building.
Three points help put $1,100.69 in context:
- It sits above the whole ranked field. The highest ranked states are New Mexico ($826.00), Colorado ($419.22), Rhode Island ($381.06), Washington ($373.84) and Kentucky ($365.78). Alaska's figure clears all of them.
- It is far from the low end. At the bottom of the ranking, Arkansas lists $70.00 a day.
- It is one published value. Alaska rates are compiled from official state Medicaid publications and each links to its source document. Nursing facility payment in many states is set facility by facility, so the Alaska Medicaid rates page is the place to confirm which figure applies to a given building.
Comparing against other high-paying states is useful. A Colorado facility receives $419.22 per resident day at the state level; the Colorado skilled nursing page shows how that rate is coded. The New Mexico skilled nursing page covers the top ranked figure.
Alaska nursing facility wages vs the national median
A daily rate has to fund round-the-clock staffing at three licensure levels. Alaska wages run above the US median at every level, according to May 2025 federal occupational data.
| Role | Alaska median hourly wage | US median hourly wage |
|---|---|---|
| Registered nurse | $52.64 | $46.90 |
| Licensed practical nurse | $38.85 | $30.96 |
| Nursing assistant (CNA) | $22.29 | $20.32 |
The licensed practical nurse gap is the widest of the three in relative terms, and LPNs often carry medication passes and treatments in a nursing home. Registered nurse time is the most expensive hour on the schedule at $52.64. Nursing assistants deliver most hands-on care, so the CNA wage of $22.29 drives the bulk of direct care cost.
Labor is only part of the story in Alaska. Supplies, food, utilities and freight all cost more to deliver, and the per diem has to absorb those costs as well. A daily rate several times the national median is the state's answer to that cost structure, not a sign of unusual margin.
Alaska Medicaid skilled nursing reimbursement changes in 2026
Alaska revisits its payment rates through public meetings and published memos, and the record shows a steady rhythm of updates:
- ORR Medicaid Swing Bed Rate for Calendar Year 2026, effective January 1, 2026, carries a 4.44% change.
- ORR Medicaid Swing Bed Rate for Calendar Year 2025, effective January 1, 2025, carried an 8.51% change.
- ORR Current Medicaid Payment Rates memo, effective July 1, 2026, carries a 2.83% change.
- Proposed Medicaid Payment Rate Public Meeting June 24, 2026 (OPN 223734), a hearing notice published May 24, 2026.
- Notice of public meeting for proposed Medicaid payment rates, for a September 23, 2026 meeting, published August 26, 2026.
Swing beds are hospital beds that can be used for nursing-level days, so the swing bed rate is a second reference point for what Alaska pays for that level of care. The two hearing notices show that proposed rates are put out for comment before they take effect. Facilities that want to influence their per diem should track those notices on the Alaska Medicaid rates page.
How Alaska pays: fee-for-service, no plan layer
Alaska Medicaid is run fee-for-service. The state sheet classifies no service lines under a managed-care payment rule and lists no directed payment programs. The plans named are Alaska Medicaid (all enrollees, FFS) and Denali KidCare CHIP, the children's coverage program.
For a nursing facility, that simplifies billing. There is no plan contract to negotiate and no network status to manage: the rate the state publishes is the rate paid. The Alaska managed care page will show any change to that model.
Related programs on the state sheet include the home and community-based waivers run by Senior and Disabilities Services, and Alaska Personal Care Services and Community First Choice. Those programs pay for care at home, which is the main alternative to a nursing home stay for the same population.
Alaska against the lowest-paying states
The bottom of the national ranking shows how different nursing home economics can be:
- Connecticut lists $107.21, attached to code 1293Z.
- Michigan lists $99.90, attached to code G9685.
- Arkansas lists $70.00 a day.
Some of those low figures are attached to codes that likely represent one component of payment, not the whole per diem, so the comparison is directional. Even so, Alaska sits at the far opposite end: a single published daily figure above every ranked state.
Reading the Alaska number correctly
Use the Alaska rate as a reference, not a forecast. Facility-specific factors such as size, cost history and resident mix can move what any one building receives. Check the effective date, January 1, 2026, against the date of service, and watch the public meeting notices for proposed changes. The national skilled nursing overview compares every state, and our methodology explains why only 21 of the 44 states with a published rate can be ranked on a single figure.
Updated 2026-10-05