Skilled nursing Medicaid rates in Rhode Island are among the highest in the country. The state's published daily rate for a nursing home stay is $381.06, effective October 1, 2026, which ranks Rhode Island 3rd of the 21 states with a comparable daily rate and puts it 34.8% above the national median of $282.59.
That rate is brand new. It is the first annual update since Rhode Island moved nursing facility payment to the Patient Driven Payment Model (PDPM) on October 1, 2025, and it took effect just days before this page was updated. Every rate here is compiled from official state Medicaid publications and linked to its source document.
Rhode Island Medicaid nursing home rate per day: $381.06
The $381.06 per diem is Rhode Island Medicaid's payment for one nursing home resident day. It covers nursing at three licensure levels, room and board, dietary, housekeeping, activities, administration and capital.
Rhode Island's October 1, 2026 PDPM rates carry a 3.79% change from the prior rate year. Under PDPM, each resident's classification drives the case-mix portion of the rate, so the statewide figure is a reference and an individual facility's actual per diem depends on the residents it serves. The Rhode Island state page lists the published rates and links each to its source document.
The PDPM transition and RUG claims
Rhode Island's move from the older RUG classification system to PDPM has been the dominant issue for its nursing facilities over the past year. The state's provider updates trace the transition:
- Provider Update 393: announced PDPM implementation on October 1, 2025.
- Provider Update 394: an implementation update with an updated PDPM guide, published November 1, 2025.
- Provider Update 402: guidance on nursing home RUG claims, published July 1, 2026.
- Provider Update 403: further guidance on nursing home RUG claims, published August 1, 2026.
- PDPM rates effective October 1, 2026: the new rate year, with a 3.79% change.
The two 2026 updates on RUG claims show that the transition was still being worked through well into the first PDPM year. For a billing team, that means knowing which classification basis applies to each claim, and paying particular attention to late or corrected claims for stays that span the changeover. Facilities that still have open RUG-era claims should follow the instructions in Provider Updates 402 and 403 closely, since guidance issued a year after the transition usually addresses problems that were affecting payment.
PDPM classifies residents by clinical characteristics rather than by therapy minutes, the same approach Medicare uses for skilled nursing stays. For a Rhode Island facility, that means assessment coding drives Medicaid revenue, and facilities already experienced with PDPM under Medicare can apply that discipline to Medicaid residents.
Managed care and Rhode Island nursing facilities
Rhode Island runs Medicaid managed care through Neighborhood Health Plan of Rhode Island, Tufts Health Public Plans and UnitedHealthcare Community Plan of Rhode Island. For nursing facilities, the rule is: paid directly by the state, outside managed care.
That means the published PDPM per diem is the payment for a Medicaid resident day, with no plan-level negotiation over the nursing facility rate. Rhode Island's MCO contract does include a state directed payments table, A21, effective July 1, 2026 and recorded with a 3.22% change, which governs directed payments made through the plans for the services they cover. We record 12 plans and related arrangements in Rhode Island. The Rhode Island managed care page explains how each service line is paid.
Our data records no prior authorization rules and no unit limit attached to code P9605 in Rhode Island.
High wages behind a high rate
Rhode Island's May 2025 wages are above the national median at every nursing level:
| Role | Rhode Island | US median |
|---|---|---|
| Registered nurse | $48.39 | $46.90 |
| Licensed practical nurse | $38.51 | $30.96 |
| Nursing assistant (CNA) | $22.33 | $20.32 |
The licensed practical nurse wage is the standout, far above the national median, and nursing assistants, who provide most direct-care hours, also earn more than the national figure. Rhode Island's high per diem is therefore paying for a high-cost workforce. A rate 34.8% above the median does not leave a margin of the same size, because the staff hours it buys cost more than in most states.
How Rhode Island compares with the top and bottom states
| State | Daily rate |
|---|---|
| New Mexico | $826.00 |
| Colorado | $419.22 |
| Rhode Island | $381.06 |
| Washington | $373.84 |
| Kentucky | $365.78 |
| National median | $282.59 |
Rhode Island sits in a tight cluster with Colorado, Washington and Kentucky, all between $365.78 and $419.22, while New Mexico's $826.00 stands alone at the top. At the other end of the ranking, Connecticut, Rhode Island's neighbor, lists $107.21, and Michigan ($99.90) and Arkansas ($70.00) set the floor. Of the 44 states with a published nursing home rate, 21 are ranked on a single daily figure.
For a Rhode Island operator, the near-term questions are practical: whether facility rates for the new October 2026 year reflect accurate PDPM classification, and whether any RUG-era claims remain open.
See the skilled nursing industry hub for every state and the methodology page for how rates are compared.
Updated 2026-10-05