Long-term Care Hospital PPS: Other Files for Download
Guidance for other files for download, including: one-time budget neutrality adjustment data, supplemental security income data file, LTCH labor market area definitions, short-stay outlier payment example, severe wound diagnosis codes, and discharge payment percentage form letter.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: March 08, 2019
One-Time Budget Neutrality Adjustment Data
The data in this file supports the analysis of the LTCH PPS One-Time Prospective Adjustment to the Standard Federal Rate provided for in §412.523(d)(3) as presented in the RY 2009 LTCH PPS Proposed Rule (January 29, 2008; 73 FR 5353 through 5360). The One-Time Budget Neutrality Adjustment Data (ZIP) file includes the data and data description.
Supplemental Security Income (SSI) Data File
The Supplemental Security Income (SSI) data (ZIP) file contains the latest available LTCH-specific SSI data to be used for purposes of payments, as applicable, for LTCH discharges (e.g., discharges paid the IPPS comparable amount under the short-stay outlier (SSO) payment adjustment under 412.529(c)(2) and (c)(3)). This ratio is used to determine an "amount comparable to the hospital inpatient prospective payment system per diem amount" that may include, where applicable, an adjustment for the costs of serving a disproportionate share of low income patients (§412.529(d)(4)). Typically, the file will be updated annually for the upcoming fiscal year (FY). (Please note that annual impact files for the respective FY proposed and final rules may reflect earlier SSI data used to estimate the "amount comparable to the hospital inpatient prospective payment system per diem amount" under the SSO policy for rate-setting purposes. The annual impact file developed for each proposed and final rules are created from the latest available data at the time the respective rule is published, and the SSI data in the impact file may differ from the file provided here.)
LTCH Labor Market Area Definitions
The Labor Market Area CBSA Crosswalk (ZIP) file contains the current LTCH PPS labor market area crosswalk and historical crosswalks that have been superseded. The current crosswalk was adopted under the LTCH PPS beginning October 1, 2024 and "crosswalks" counties to the current CBSA delineations.
Short-Stay Outlier Payment Example
The Short-Stay Outlier Payment Example (ZIP) file contains two examples that illustrate the computation of the adjusted payment for short-stay outlier (SSO) cases effective for LTCH PPS discharges occurring on or after July 1, 2006 (established in the RY 2007 final rule) versus the SSO payment adjustment effective for discharges occurring on or after July 1, 2007 and on or before December 28, 2007 (originally established in the RY 2008 final rule, as amended consistent with section 114(c)(3) of Public Law 110-173) under §412.529(c).
Severe Wound Diagnosis Codes by Category
The Severe Wound Diagnosis Codes by Category (ZIP) file contains the severe wound diagnosis codes by category for implementation of the section 231 of the Consolidated Appropriations Act, 2016, which establishes a temporary exception from the site neutral payment rate for patients discharged from certain LTCHs with a “severe wound,” as implemented in an interim final rule with comment period (IFC) published in the Federal Register on April 21, 2016 (CMS‑1664-IFC). These same codes are also used to implement section 15010 of the 21st Century Cures Act, which provides a temporary exception from the site neutral payment rate for patients discharged from certain LTCHs with a “severe wound” as implemented in the FY 2018 IPPS/LTCH PPS final rule (CMS-1677-F).
Discharge Payment Percentage (DPP) Form Letter
The DPP Form Letter (PDF) file contains a form letter the MACs may use when informing LTCHs of their cost reporting period DPP. The DPP is the ratio (expressed as a percentage) of the LTCHs’ FFS discharges which received LTCH PPS standard Federal rate payment to the LTCHs’ total number of LTCH PPS discharges.
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