Updated September 6, 2026. Quick answer: In Virginia, a Medicaid nursing-facility resident’s Personal Needs Allowance is $40.00/Month; the amount of their own income they keep for personal use each month, with the rest going to the facility as the patient-pay amount toward the cost of care. That is well above the $30/month federal floor set in 1988 and never raised since. Virginia Medical Assistance Eligibility Manual, Chapter M14 “Long-Term Care,” Section M1470.210: Facility Personal Needs Allowance states the figure directly.
Why Virginia’s figure isn’t the federal floor
Federal Medicaid law requires only a $30-a-month personal needs allowance as a floor; a state is free to set its own, higher figure by statute, regulation, or agency policy. Virginia has done exactly that, setting $40.00/Month, effective manual file dated 4-1-24; this specific page’s own internal revision stamp reads “May 2015”.
What the allowance covers, and what it doesn’t
The personal needs allowance pays for the things a facility’s daily rate doesn’t cover: clothing, haircuts, snacks, a phone or television, small personal purchases. It is deducted before the rest of a resident’s income is applied to the facility bill as the patient-pay (or post-eligibility treatment of income, PETI) amount. It is not extra money on top of what Medicaid already pays the facility; it is the one slice of a resident’s own income that Medicaid rules guarantee the resident, not the facility, keeps.
One exception or caveat worth knowing
The page’s own internal revision stamp reads “May 2015” even though it sits inside a manual file dated April 2024; could mean the $40 figure has simply been unchanged since 2015 (the whole manual is republished on each transmittal), or that this page was overlooked in a later revision. No more-recent VA primary source found contradicting $40.
| Citation | Virginia Medical Assistance Eligibility Manual, Chapter M14 “Long-Term Care,” Section M1470.210: Facility Personal Needs Allowance |
| What it says | “M1470.210 FACILITY PERSONAL NEEDS ALLOWANCE … 1. Basic Personal Allowance Deduct $40 per individual.” |
Every citation on this page was read directly from the state’s own Medicaid agency, administrative code, or official eligibility manual this session. General information, not legal or financial advice; a figure this specific can change with a budget cycle or a rule amendment, and a facility or state caseworker has the final say on any individual case.