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.
Data statusReference Only
- Status
- Reference Only
- Data year / effective
- FY2026
- Last reviewed
- June 2026
- Last updated
- June 2026
- Primary source
- CMS IPPS/LTCH PPS Final Rule, FY2026
- Known exclusions
- Wage index varies by CBSA
- Site-neutral vs standard-rate determination is case-specific
- High-cost-outlier and short-stay-outlier adjustments vary
- Sequestration and MAC edits not applied
Published reference for the stated period — confirm the current figure and any corrections at the source before billing.
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 |
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.
