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amount ($10,000) and the outlier payment amount ($29,540). IPPS Outlier Payment Policy Changes In the 2003 IPPS Final Rule, CMS made changes to its outlier payment
A short-stay outlier payment may occur in one of the following scenarios: Background What Are Long-Term Care-Diagnosis Related Groups? Under the Medicare system, Long-Term Care Hospitals (LTCHs) generally treat patients who require hospital-level care for an average of greater than 25 days.n other words, a patientâs remaining amount of benefit days and the length of a hospital stay can affect LTCH payment, resulting in a short-stay outlier payment. For example: But. . . The LTC-DRG short-stay outlier threshold is 25 days, and the patientâs benefit days end on Day 30.