Updated August 27, 2026. Quick answer: MassHealth divides by a DAILY figure, and it is $450.00 for applications received on or after November 1, 2025, up from $441.00. Which of the two applies is not decided by when the gift was made or when the penalty is calculated — EOM 25-16 is explicit that it turns on the date MassHealth received the application or the eligibility review form. A file received on October 31 is worked at $441.00; the same file received a day later is worked at $450.00.
What Massachusetts publishes
| What the state lists | Figure |
|---|---|
| Current divisor (daily) | $450.00 |
| Applies to | applications or eligibility review forms RECEIVED on or after November 1, 2025 |
| Previous divisor (daily) | $441.00 — for files received before November 1, 2025 |
| What decides which figure applies | the date MassHealth received the application or eligibility review form |
| What the figure represents | the average daily cost to a patient paying privately for nursing facility services in the Commonwealth |
| Who sets it | MassHealth, by Eligibility Operations Memo — not by amending the regulation |
| The memo that sets it | EOM 25-16, dated October 2025 |
| The rule it serves | 130 CMR 520.019(G)(1) |
| Look-back | 60 months for transfers on or after February 8, 2006 — 130 CMR 520.019(B)(2) |
| Partial months | imposed, not forgiven — MassHealth “does not round down or disregard any fractional period of ineligibility” |
| Multiple transfers after 2/8/2006 | added together and divided once, producing a SINGLE penalty period |
| Revision cadence | no fixed schedule — the memo says only that the figure is revised “periodically” |
How the penalty period is calculated
- 130 CMR 520.019(G)(1) states the division: the total cumulative uncompensated value of all resources transferred by the nursing-facility resident or the spouse, divided by the average cost to a private patient receiving nursing-facility services in the Commonwealth “at the time of application, as determined by the MassHealth agency.”
- The regulation and the operative memo do not use the same unit, and this is worth knowing before you reach for a calculator. The text of 520.019(G)(1) says “average MONTHLY cost”; EOM 25-16, which cites that exact subsection, publishes an average DAILY cost and instructs staff to use it. This page reports the figure MassHealth actually issues, per day, and does not convert it to a monthly equivalent, because MassHealth does not publish one.
- Because the divisor is daily, the quotient is a number of DAYS of ineligibility, not months. A $90,000 gift at $450.00 a day is 200 days.
- A fractional period is imposed rather than dropped. 130 CMR 520.019(G)(2)(d): if the calculated period is less than one month, MassHealth “imposes a partial-month period of ineligibility and does not round down or disregard any fractional period.”
- Transfers that produce overlapping periods are added and divided once. Non-overlapping transfers made on or after February 8, 2006 are also added together under 520.019(G)(2)(i), producing one period beginning at the later of the first transfer month or the date the person is otherwise eligible for long-term-care services.
- A transferred stream of income is handled payment by payment: MassHealth calculates a period for each periodic payment transferred, and may impose partial-month periods for each.
Once you have the figure above, the Medicaid penalty period calculator does the arithmetic. This page is the Massachusetts rate record; the calculator is the class parent.
What this page does not settle
- This page does not tell you whether MassHealth will treat a particular transfer as disqualifying. The exceptions, the trust rules at 130 CMR 520.023, and annuity treatment each turn on documents in a specific file.
- The figure is set by memo rather than by regulation, which means it can change without any amendment to 130 CMR 520.000. EOM 25-16 says only that the figure is revised “periodically” to reflect increased costs, so there is no published date on which the next change is due. Confirm the current memo before relying on the number.
- $450.00 a day is MassHealth’s administrative average for computing a penalty. It is not a quotation of what any particular Massachusetts nursing facility charges, and rates in the Commonwealth vary widely around it.
- Denial of payment for nursing-facility services does not end MassHealth eligibility for other benefits — 130 CMR 520.018(C) says so in terms. A penalty period is not a loss of coverage generally.
- Where any part of 130 CMR 520.018 or 520.019 conflicts with 42 U.S.C. 1396p, the regulation states that federal law supersedes.
Eligibility is decided by the state agency on the whole file, not by this one number. Nothing here is legal advice, and no one should transfer, retitle or give away property on the strength of a worksheet.
Sources
- MassHealth Eligibility Operations Memo 25-16, Average Daily Cost of Nursing Facility Services for Calculating a Period of Ineligibility (October 2025)
- 130 CMR 520.000: MassHealth Financial Eligibility — including 520.018 and 520.019, Transfer of Resources
- MassHealth, Eligibility Operations Memos by Year — the index this memo was found in and where a superseding memo would appear
Each source above was retrieved and read against the state text on August 27, 2026. Every figure on this page was checked against those bytes.
The penalty divisor governs transfers, not eligibility. For the income side, see Massachusetts’s Medicaid nursing-home income test, which gives the figure or mechanism and the state regulation it comes from.