Texas Nursing Home Costs in 2026: Average Monthly Price

How much does a Texas nursing home cost per month?

The CareScout Cost of Care Survey is the survey most state agencies, insurance carriers, and financial planners use for long-term care pricing. Its 2025 edition, with fieldwork from July through November 2025, reports these Texas medians:

Source: CareScout Cost of Care Survey, 2025 edition, Texas and national median cost tables. Monthly figures are the survey's published monthly medians, or the annual median divided by 12 where the survey publishes the annual figure.

Two notes on reading these numbers. First, a median is not a bill: half of the surveyed Texas facilities reported rates below these figures and half reported rates above them. Second, the rate a facility quotes is often the base rate. Therapy supplies, incontinence products, transportation, and a private-room premium typically sit outside it. We cover those extras in the costs that are not in the quoted monthly rate.

How does Texas compare with the national median?

The national median in the same 2025 survey was $9,581 a month for a semi-private room and $10,798 for a private room. Texas sits below both, and it is not a near miss: it has the lowest semi-private median of the 50 states the survey reports, and its private-room median is tied with Missouri for the lowest in the country.

For a family that is comparing settings rather than states, the same survey puts in-home care in Texas at a median of $30 an hour, versus a national median of $35 an hour. Assisted living costs less than a nursing home in Texas the same way it does nationally, because assisted living is not required to staff licensed nursing coverage around the clock. Whether that saving is available to your family depends on the level of care the person needs, not on the price difference.

Semi-private or private room: what is the difference in price?

The gap in Texas is $1,977 a month, or about $23,725 a year, between a semi-private and a private room. That is the single largest optional line item most families encounter, and it is usually not covered: Medicare pays for a private room only when it is medically necessary, and Texas Medicaid has the same standard, so a family that wants a private room for privacy typically pays the difference out of pocket.

One practical point. Private-room availability in Texas is not purely a budget question, and the gap between the two medians is smaller than in most states because the shared room is already cheaper here. Facilities keep a limited number of private rooms, so the decision is often made by availability at the time of admission rather than by price alone.

What keeps Texas nursing home prices low?

Labor is the largest single cost in a nursing home, and Texas has held its wage floor low. The state adopts the federal minimum wage rather than setting a higher one of its own: Texas is at $7.25 an hour, and the Texas Workforce Commission is the agency that enforces it, alongside the U.S. Department of Labor for covered employers. Cities in Texas also cannot raise the local private-sector rate above the state floor. That gap against a high-wage state is one reason the Texas medians sit at the bottom of the survey rather than the middle.

Skilled nursing is still a licensed-nursing setting. Nursing homes must have licensed nursing staff on duty on every shift, plus a medical director, infection control oversight, and compliance staff that a residential care setting does not carry. Federal and state survey requirements add administrative and reporting cost on top of direct care. Real estate and local labor markets explain the rest of the state-to-state gap: the same building and the same staffing model costs more in a metro area than in a rural county, which is why the statewide median is a starting point and not a quote. The survey also publishes medians for metro areas if you need a local figure.

Does Medicare pay for a nursing home stay in Texas?

Medicare Part A pays for skilled nursing facility care for up to 100 days per benefit period, and only after a qualifying inpatient hospital stay of at least three days. The structure is the same in Texas as anywhere else, because it is a federal benefit. The 2026 amounts, from the CMS fact sheet on 2026 Medicare Parts A and B premiums and deductibles, are:

Using all 80 coinsurance days at $217 works out to about $17,360 in the year, and many Medigap plans cover that coinsurance. The larger point for a Texas family is structural: Medicare pays for recovery, not for residential care. Long-term custodial care, which is help with bathing, dressing, eating, and supervision, is excluded. A resident who needs that level of help for years is not a Medicare case, which is why the next section matters more in practice. Our Medicare nursing home coverage guide walks through the qualifying-stay rules in more detail.

Does Texas Medicaid pay for nursing home care?

Yes. Texas Medicaid, administered by the Texas Health and Human Services Commission (HHSC), is the largest payer for long-stay nursing home care in the state. To qualify, an applicant generally must need nursing-facility level of care and meet the state's income and resource rules. The 2026 limits, from the Texas HHSC Medicaid for the Elderly and People with Disabilities Handbook, are:

Source: Texas HHSC Medicaid for the Elderly and People with Disabilities Handbook, Appendix XII and Appendix XXXI, effective January 1, 2026.

The income limit is the "special income limit," which Texas sets at 300% of the SSI federal benefit rate. For 2026 the SSA set that rate at $994 a month for an individual and $1,491 for a couple, which is where the $2,982 and $5,964 figures come from. Three more rules matter most for planning in 2026:

1. Most income goes to the facility. A nursing home resident on Texas Medicaid must contribute most of their gross monthly income toward the cost of care, keeping only the $75 personal needs allowance plus health insurance premiums and similar deductions. Medicaid covers the balance. This is why the monthly price above matters even for a family that expects Medicaid to help: the state pays the difference between the resident's share of cost and the facility's Medicaid rate.
2. A married resident's spouse keeps a protected share. The community spouse can protect countable resources between $32,532 (the federal minimum) and $162,660 (the federal maximum), and the spousal allowance used in the co-payment calculation is $4,066.50 a month. Spousal impoverishment protections exist so the at-home spouse is not left with nothing.
3. Transfers are reviewed for five years. Texas uses the standard 60-month look-back for long-term care Medicaid, measured from the later of institutionalization or the application date. Gifts or transfers made in that window can trigger a period of ineligibility, calculated in Texas by dividing the transferred amount by the state's average private-pay rate, which HHSC lists as a $262.37 daily divisor as of September 1, 2025. The look-back rules are worth reading before you file anything.

Texas also applies a substantial-home-equity limit of $752,000, and it exempts the homestead the person plans to return to, one vehicle, life insurance with a face value of $1,500 or less, and burial funds of $1,500. A home worth more than the equity limit can make an applicant ineligible, so the house is usually the first thing to check. Applications in Texas are handled by HHSC through Your Texas Benefits, and 2-1-1 Texas can route you to help; our Medicaid nursing home coverage guide covers what Medicaid does and does not pay for once a resident qualifies.

How do I check what a specific facility charges?

Ask the admissions office for the current rate schedule in writing, and ask which services sit outside the base rate. Medicare's official Care Compare tool (medicare.gov/care-compare) lists every Medicare-certified nursing home in Texas with staffing levels, inspection results, and ownership information, which lets you compare facilities on more than price. Texas nursing facilities are licensed and inspected by the Texas Health and Human Services Commission, which publishes provider information and handles complaints through its provider and complaint channels.

You can also estimate the yearly number for your own situation with our care cost calculator, and compare the state against others in nursing home costs by state. The nursing home cost hub page for Texas is at Texas nursing home costs.

Where these numbers come from

State cost figures are medians from the CareScout Cost of Care Survey, 2025 edition, fieldwork July through November 2025: the Texas row and the national row of the published median cost tables, and the survey's ranking table for the state comparison. Medicare amounts for 2026 come from the CMS fact sheet on 2026 Medicare Parts A and B premiums and deductibles, and the 100-day limit and the distinction between skilled care and custodial care come from Medicare.gov. The 2026 SSI federal benefit rate is from the Social Security Administration. Texas Medicaid income limits, resource limits, the $75 personal needs allowance, the protected resource range for a community spouse, the spousal allowance, the substantial-home-equity limit, the transfer-of-assets divisor, and the 60-month look-back are from the Texas Health and Human Services Commission Medicaid for the Elderly and People with Disabilities Handbook. Texas minimum wage information is from the Texas Workforce Commission and the U.S. Department of Labor. Facility quality and inspection information comes from Medicare Care Compare and the Texas Health and Human Services Commission. This is general information about program rules, not financial, legal, or tax advice for a particular situation.