Assisted Living Waiver
Assisted Living Waiver rates by tier
The 2026 daily rates Medi-Cal pays an assisted-living home for each ALW care tier, the care coordination rate, how the tier is decided, and the 2023 rates for comparison.
These are the daily amounts Medi-Cal pays a participating assisted-living home for each care tier under the Assisted Living Waiver (ALW) in 2026, plus the monthly care coordination rate. The California Department of Health Care Services (DHCS) sets them. They are paid to providers, not to residents. Residents pay room and board (the room and meals) separately, from their own income.
Important: A tier rate is not a bill to the resident. A home or agency should not promise a tier before the nurse assessment, because DHCS sets the tier after it. Beta's ALW team can explain how the rates work. Beta can't promise a tier, eligibility, an opening or a placement.
2026 rates by tier
DHCS published these maximum payable rates, effective January 1, 2026. The monthly column is our arithmetic: the daily rate times 30.4 days, rounded to the dollar. It is not a DHCS figure.
| Tier | Per participant per day | About per month, 30.4 days |
|---|---|---|
| Tier 1 | $95.69 | $2,909 |
| Tier 2 | $114.33 | $3,476 |
| Tier 3 | $132.97 | $4,042 |
| Tier 4 | $179.58 | $5,459 |
| Tier 5 | $270.80 | $8,232 |
Care coordination is paid separately: $320.00 per participant per month to the Care Coordination Agency (CCA), the state-listed organization that does the ALW paperwork and care planning with the resident. DHCS says the 2026 rates rose with the state minimum wage, which went up to $16.90 on January 1, 2026.
Try the rate calculator: pick a tier and the days in the home to see the month's arithmetic.
How the tier is decided
A registered nurse from the agency assesses how much help the person needs, day and night. DHCS reviews the assessment and applies its level-of-care standard. The tier comes from the person's needs. A higher tier means more care and a higher daily rate. Nobody can say in advance which tier a person will get, and no home or agency should promise one. How the assessment works.
What the resident pays
ALW does not pay room and board. The resident pays it from income. In 2026 a resident whose only income is SSI/SSP (Supplemental Security Income plus the State Supplementary Payment) receives $1,626.07 a month. The home may charge at most $1,444.07 for basic services: $706.07 for room and board plus up to $738.00 for care and supervision. The resident keeps at least $182.00. These figures come from California Department of Social Services (CDSS) notice PIN 25-19-CCLD. What ALW pays for and what you pay.
Rate history
| Tier | 2023, per day | 2026, per day |
|---|---|---|
| Tier 1 | $88.60 | $95.69 |
| Tier 2 | $105.86 | $114.33 |
| Tier 3 | $123.12 | $132.97 |
| Tier 4 | $166.27 | $179.58 |
| Tier 5 | $250.00 | $270.80 |
The 2023 figures come from the DHCS 2023 rate sheet. For any other year, use the DHCS sheet for that year.
For facility owners
If you run a licensed Residential Care Facility for the Elderly (RCFE) or Adult Residential Facility (ARF), the rate is per participant per day, for the days the person lives in your home as an enrolled ALW participant. DHCS sets the billing and claiming rules in its policy letters. ALW Policy Letter 26-002 (September 25, 2026) covers claiming: claims are only for enrolled participants and approved services, and the agency confirms each participant's enrollment and sends your facility an informing notice. The current letters are on the DHCS provider resources page. Resources for RCFEs and ARFs.
Do ALW rates go up every year?
Not automatically. DHCS publishes a rate sheet when the rates change. The 2026 increase followed the minimum wage increase. Check the DHCS ALW page for the current sheet.
Does the rate include room and board?
No. The rate sheet itself says ALW does not pay room and board. The resident pays that separately.
Can a home charge the resident more than the SSI amount?
For a resident on SSI/SSP, the charge for basic services is capped at $1,444.07 in 2026. The home may charge $20 more a month if the resident has income besides SSI/SSP and the admission agreement says so. A private room or special food services may be charged by agreement, within the CDSS limits. For a resident whose income is not SSI/SSP, DHCS does not cap room and board, so ask the home for its rate in writing.
About this informationReviewed October 12, 2026. Program details may change. View official sources and page limitations.
Written by Beta's ALW team and checked against the official sources this page lists; facts checked through October 12, 2026. Where this page and an official source differ, the source controls.
This page gives general California ALW information. DHCS decides eligibility after the nurse assessment and releases openings. Each home decides its own admissions. Nothing here is an eligibility decision or a promise of enrollment, and it does not guarantee a place in a home. You may choose any Care Coordination Agency listed by DHCS and any participating home.
Something out of date? Tell Beta's ALW team.