New Fee Schedule for Long-Term Care Hospitals

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Categories: Medical Provider All News Medical Provider Billing

Effective January 1, 2020, WSI will implement a new Fee Schedule for Long-Term Care Hospital (LTCH) charges. The LTCH Fee Schedule will require a provider to bill LTCH charges upon discharge only, and will not allow for reimbursement of bills submitted as an interim stay. WSI will reimburse inpatient LTCH services based on Diagnosis Related Groups (DRGs) using the following Standard Calculation Formula:

        Base Rate X Medicare's MS-DRG Weights = Reimbursement Rate

For 2020, the Base Rate is $237,000.00 

WSI will post the LTCH Fee Schedule Guideline under Fee Schedule Guidelines on January 1, 2020. Additional information provided in the LTCH Fee Schedule Guideline will include:

  • Reimbursement Methodologies for High Cost Outlier, Short Stay Outlier, and Interrupted Stay
  • Payment Parameters
  • Billing Requirements
  • Reimbursement Procedures

If you have questions about this article, or to request an advance copy of the LTCH Fee Schedule Guideline, please send an email to wsipr@nd.gov. To receive provider news, subscribe to our Email Updates list. 

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