Long-Term Care Hospital · Overview
Long-Term Care Hospital (LTCH) PPS
How Medicare pays long-term care hospitals — the standard federal rate for cases that meet LTCH criteria, the site-neutral rate for those that don't, high-cost and short-stay outliers — plus a FY 2026 payment estimator.
No PHIEstimator · BetaRuns entirely in your browser — no data leaves the page. Rates are CMS FY 2026 final-rule values; verify against the LTCH Pricer and your MAC.
Two payment paths
FY 2026Each LTCH discharge is paid one of two ways, depending on whether the case meets the statutory LTCH criteria (a qualifying 3-day-plus ICU stay or prolonged mechanical ventilation):
| Standard federal rate | MS-LTC-DRG relative weight × $50,824.51, wage-adjusted on the 72.9% labor share; high-cost outlier above $78,936 |
| Site-neutral rate | for cases that don't meet criteria — the lesser of the IPPS-comparable amount or 100% of estimated cost |
Short stays (covered length of stay at or below ⅚ of the MS-LTC-DRG geometric average) are paid as short-stay outliers, which reduces payment. The estimator flags these.
LTCH Payment Estimator →
Standard or site-neutral, with high-cost-outlier and short-stay-outlier handling, for FY 2026.
LTCH PPS Rates & Method →
The FY 2026 standard rate, HCO and site-neutral thresholds, labor share, and the full payment logic.
How a Medicare claim is built →
Bill types, revenue codes, and the UB-04 — background for LTCH institutional claims.