US · guidance
CMS Pub. 100-04, ch. 3, § 150.9.1.3
Payments for Special Cases
Payments for short-stay outliers are determined in the Pricer logic. Payments for
interrupted stays are based on properly submitted bills by the LTCHs, which are described
in billing instructions.
More than one case-level adjustment may apply to the same case. For example, a case
may be a short-stay outlier and also be governed by either the 3-day or less or greater than
3-day interruption of stay policy and therefore only generate 1 LTC-DRG payment to the
LTCH.
History
(Rev. 1816; Issued: 09-17-09; Effective Date: Discharges on or after October 1, 2009; Implementation Date: 10-05-09)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
7823815fcb33a428e31606f0052d390bc09044c3ae819a338b0ad458da233a5d
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