US · guidance
CMS Pub. 100-04, ch. 3, § 150.17.1
Assumptions for Use in Examples Below
1. Cost outlier threshold amount is $50,000
2. Threshold amount is reached on the 25th day
3. The DRG ALOS equals 12 days, therefore, the Short Stay Threshold equals 10
days
4. Billed charges are $3,000 per day for the first 12 days, $2,000 on the 13th day and
$1,000 each day thereafter
5. Beneficiary elects to use any available LTR days
History
(Rev. 1, 10-01-03)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
7fd18825ef5d06bac35195723d9d5fff4eb05410a6614763c205957dd0e54907
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