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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
Example: If the ALOS for a particular LTC-DRG is 30 days, then the short-stay outlier policy applies to stays that are 25 days or less in length (i.e., 5/6 of 30 days = 25 days).ases qualify as a short-stay outlier when the Length of Stay (LOS) is between one day and up to, and including, 5/6 of the ALOS for the LTC-DRG to which the case is grouped. A length of stay that exceeds 5/6 of the ALOS for the LTC-DRG for the case is considered to have exceeded the short-stay outlier threshold.