Out of State / Borderland Nursing Facilities
Reimbursement Rate Limit
The routine nursing care per diem rate for the out of state (borderland) nursing facility is the
lesser of the individual Provider’s home state Medicaid rate or the Michigan Medicaid out of
state provider ceiling rate. The ceiling rate is effective for the time period coinciding with the
State fiscal year rate period October 1 through September 30 (effective October 1, 2003). The
ceiling rate is the sum of three components:
1) Class I nursing facility Variable Cost Limit (VCL) for the corresponding rate year;
2) Economic Inflationary Update; and
3) most recent Plant Cost 80th Percentile per diem amount ($5.66)
The Variable Cost Limit is reduced by applicable nursing facility policy or Governor’s Executive
Order(s).
Rate Period Beginning Total
Reimbursement
On or After AND Prior To Rate Limit
10/01/2001 12/31/2001 $125.31
01/01/2002 09/30/2002 $124.11
10/01/2002 02/28/2003 $126.99
03/01/2003 09/30/2003 $124.75
10/01/2003 09/30/2004 $135.49
10/01/2004 09/30/2005 $140.02
10/01/2005 09/30/2006 $146.94
10/01/2006 09/30/2007 $153.34
10/01/2007 09/30/2008 $160.36
10/01/2008 09/30/2009 $166.60
10/01/2009 09/30/2010 $176.04
10/01/2010 09/30/2011 $179.81
10/01/2011 09/30/2012 $184.89
CAPITOL COMMONS 400 SOUTH PINE LANSING, MICHIGAN 48909
www.michigan.gov/mdch 1-517-335-5356