Long-Term Care Hospital · Reference
LTCH PPS Rates & Method
The verified FY 2026 LTCH PPS national values, the standard and site-neutral payment paths, and how high-cost and short-stay outliers work. Effective for discharges on or after October 1, 2025.
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.
No PHIEstimator · BetaRuns entirely in your browser — no data leaves the page. Rates are CMS FY 2026 final-rule values; MS-LTC-DRG relative weights live in the CMS DRG table — verify against the LTCH Pricer and your MAC.
FY 2026 national values
CMS-1833-F| Element | FY 2025 | FY 2026 |
|---|---|---|
| Standard federal payment rate | $49,383 | $50,824.51 |
| High-cost outlier threshold · standard | $77,048 | $78,936 |
| Fixed-loss amount · site-neutral (IPPS) | $49,237 | $40,397 |
| Labor-related share | 72.8% | 72.9% |
Source: FY2026 IPPS/LTCH PPS Final Rule (CMS-1833-F). Net standard-rate update +2.7%. The standard wage index is the IPPS pre-rural-floor, pre-reclassification hospital wage index. CMS applies a total CCR ceiling per the rule.
Standard federal payment
Meets LTCH criteria| Unadjusted | MS-LTC-DRG relative weight × $50,824.51 |
| Wage adjustment | rate × (0.729 × wage index + 0.271) — only the labor share moves with the wage index |
| High-cost outlier | if (CCR × charges) > payment + $78,936, add 80% of the excess |
| Short-stay outlier | covered LOS ≤ ⅚ of the MS-LTC-DRG geometric average LOS → payment is reduced to the least of several amounts |
Site-neutral payment
Does not meet criteriaCases that don't meet the LTCH criteria are paid the lesser of:
| IPPS-comparable amount | an IPPS-equivalent per-diem (with its own cost outliers using the $40,397 fixed-loss amount) |
| 100% of estimated cost | facility CCR × covered charges |
MS-LTC-DRG relative weights and geometric average lengths of stay are published in the CMS DRG table and are not reproduced here. The site-neutral path needs the IPPS-comparable amount from the IPPS pricer. Enter those values in the estimator.
