LTC-DRG Files

Under the LTCH PPS, patients are classified into distinct diagnostic groups based on clinical characteristics and expected resource needs. The patient classification system groupings under the LTCH PPS are called long-term care diagnosis-related groups (LTC-DRGs). The LTC-DRGs are the same DRGs used under the hospital inpatient prospective payment system (IPPS), but they have been weighted to reflect the resources required to treat the type of medically complex patients characteristic of LTCHs. Relative weights for the LTC-DRGs reflect resource utilization for each diagnosis and account for the variation in cost per discharge. Under the LTCH PPS, the LTC-DRG relative weights are updated annually for each Federal fiscal year (October 1st through September 30th) using the most recently available LTCH claims data. Beginning in FY 2008, we adopted the refined severity-adjusted DRGs that were also adopted under the IPPS, that is, the Medicare-Severity-LTC-DRGs (MS-LTC-DRGs), which continue to be weighted to account for the difference in resource use by LTCH patients. 

Below are all of the LTC-DRG files since the implementation of the LTCH PPS.

FY 2021 - FY 2024 LTC-DRG Files

• FY 2021 MS-LTC-DRG File (Table 11) (ZIP)
• FY 2022-MS-LTC-DRG File (Table 11) (ZIP)
• FY 2023-MS-LTC-DRG File (Table 11) (ZIP)
• FY 2024-MS-LTC-DRG File (Table 11) (ZIP)

FY 2011 - FY 2020 LTC-DRG Files

• FY 2011 MS-LTC-DRG File (Table 11) (ZIP)
• FY 2012 MS-LTC-DRG File (Table 11) (ZIP)
• FY 2013 MS-LTC-DRG File (Table 11) (ZIP)
• FY 2014 MS-LTC-DRG File (Table 11) (ZIP)
• FY 2015 MS-LTC-DRG File (Table 11) (ZIP)
• FY 2016 MS-LTC-DRG File (Table 11) (ZIP) – Updated 09/2015
• FY 2017 MS-LTC-DRG File (Table 11) (ZIP) – Corrected
• FY 2018 MS-LTC-DRG File (Table 11) (ZIP) – Corrected
• FY 2019 MS-LTC-DRG File (Table 11) (ZIP) – Corrected
• FY 2020 MS-LTC-DRG File (Table 11) (ZIP)

FY 2003 - FY 2010 LTC-DRG Files

• FY 2003 LTC-DRG File (effective 10/1/2002 - 9/30/2003) (ZIP)
• FY 2004 LTC-DRGs Relative Weights & Average Lengths of Stay (Table 11) (ZIP)
• FY 2005 LTC-DRG File (effective 10/1/2004 - 9/30/2005) (ZIP)
• FY 2006 LTC-DRG File (effective 10/1/2005 - 9/30/2006) (ZIP)
• FY 2007 LTC-DRG File (effective 10/1/2006 - 9/30/2007) (ZIP) - updated to include the "IPPS Comparable Threshold" for revised Short-Stay Outlier payment formula effective 07/01/2007
• FY 2008 MS-LTC-DRGs, Relative Weights & Thresholds (Table 11) (ZIP)
• FY 2009 MS-LTC-DRG File (effective 10/1/2008 – 6/2/2009) (ZIP)
• FY 2009 MS-LTC-DRG File (effective 6/3/2009 – 9/30/2009) (ZIP)
• FY 2010 MS-LTC-DRG File (effective 10/1/2009 - 9/30/2010) (ZIP)