Updated September 17, 2026. Quick answer: In Nevada, a Medicaid nursing-facility resident’s Personal Needs Allowance is $154.00/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. Nevada DWSS Medical Assistance Manual, Section F-120.5, “Patient Liability Budgeting Procedures” states the figure directly.
Why Nevada’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. Nevada has done exactly that, setting $154.00/Month, effective January 1, 2024 under Nevada’s Medicaid State Plan, which adjusts the figure annually by the Social Security cost-of-living adjustment (the DWSS manual chapter dated MTL 08/25 still prints $154).
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 manual does not print a discrete effective-date line for the $154 figure; Nevada’s Medicaid State Plan (Attachment 2.6-A, page 4a) lists $154 effective January 1, 2024 and states the figure is adjusted annually by the Social Security cost-of-living adjustment.
| Federal personal needs allowance floor | $30.00/month |
| Nevada’s personal needs allowance | $154.00/Month |
| How far above the federal floor (calculated by comparing this state’s own figure to the $30.00 federal floor) | 413% higher |
| State citation | Nevada DWSS Medical Assistance Manual, Section F-120.5, “Patient Liability Budgeting Procedures” |
| What it says | “Deduct a $154 personal needs allowance (PNA) for each month of institutionalization.” |
| Federal floor citation | 42 CFR § 435.725 (the federal $30.00/month personal needs allowance floor) |
Figures verified against the Nevada DWSS Medical Assistance Manual chapter F-100 (MTL 08/25), 42 CFR § 435.725 and 42 U.S.C. § 1396a(q) on September 30, 2026; the 1988 date of the federal floor was not re-checked.
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.