Only for certain amounts. During a skilled nursing stay that Medicare covers, the facility generally can charge you only the Medicare coinsurance, which in 2026 is $0 a day for days 1–20 and $217 a day for days 21–100. Federal rules say a Medicare provider agrees not to charge you for services Medicare pays for, beyond the deductibles and coinsurance the law allows.
What does the federal rule say?
Nursing homes that take Medicare sign a provider agreement. Under 42 CFR 489.21, the provider agrees not to charge you for:
- Services Medicare pays for.
- Services Medicare would have paid for if the provider had done its own paperwork, like having the doctor's certification on file.
Under 42 CFR 489.30, the provider may charge you the skilled nursing facility coinsurance amount. For 2026, CMS lists that amount at $217 a day for days 21 through 100.
So for covered days, the bill should generally be limited to that coinsurance, plus any items you chose that Medicare doesn't cover.
For the basics of when Medicare covers a skilled nursing stay, including the 3-day inpatient rule, see skilled nursing facility bills and Medicare. This page is about what the facility can and can't put on your bill.
What can a nursing home charge during a covered stay?
- Days 21–100 coinsurance: $217 a day in 2026. See the $217-a-day coinsurance and who covers it.
- Items or services you choose that Medicare doesn't cover. Medicare.gov says covered care includes a semi-private room, meals, skilled nursing, therapy, drugs, and supplies. Things beyond that, like personal phone or TV service, may be charged. Ask for prices in writing before you agree.
What can't it charge?
- Covered days 1–20. Medicare.gov lists $0 for these days in a benefit period.
- Extra fees for covered care, like a separate charge for therapy, drugs, or supplies during a covered stay.
- Charges because of the facility's own paperwork errors, like a missing doctor certification, under 42 CFR 489.21.
- Any amount the Medicare Summary Notice says you don't owe.
If you're in the Qualified Medicare Beneficiary (QMB) program, Medicare.gov says Medicare providers can't bill you for Medicare deductibles, coinsurance, or copays for covered services. That includes the skilled nursing coinsurance. See Medicare Savings Programs.
Can a nursing home ask for a deposit?
Federal rules don't give a simple yes or no on deposits for a skilled nursing stay. A separate Medicare rule on prepayment (42 CFR 489.22) applies to inpatient hospital services, according to CMS's Medicare Claims Processing Manual, so don't rely on it for a nursing home.
What federal nursing home rules (42 CFR 483.15) do say is that a facility must not:
- Require a third party, like an adult child, to guarantee payment as a condition of admission or of staying. A family member with legal access to the resident's money can be asked to sign to pay from the resident's income or resources, without taking on personal liability.
- Ask you to waive your rights to Medicare or Medicaid, or to promise you won't apply for them.
If a facility asks for a deposit before a stay Medicare is expected to cover, ask why, and ask for the request in writing.
What to say to the admissions office:
"Medicare is expected to cover this stay after a qualifying hospital stay. Can you explain why you're asking for a deposit? Please put the amount and the reason in writing."
What if the stay wasn't actually covered?
Sometimes a facility thinks Medicare will stop paying. In Original Medicare, before the facility can make you responsible for care Medicare may not pay for, CMS says it must give you a Skilled Nursing Facility Advance Beneficiary Notice (SNF ABN). See the SNF ABN: your three choices.
If your covered services are ending, you should get a Notice of Medicare Non-Coverage, with fast appeal rights. See Medicare Advantage plan ended nursing home rehab coverage for those steps, which apply in Original Medicare too.