Distinct Part Pediatric Subacute
DP/PSA reimbursement will shift from an August to July rate year basis to a calendar rate year basis, effective January 1, 2024, as approved in State Plan Amendment 23-0032.
CY 2026 Rates
CY 2026 Rate Study
The document below contains the final model for DP/PSA CY 2026 rates in accordance with the Medi-Cal Long-Term Care Reimbursement Act (Welfare & Institutions Code Section 14105) and the California Medicaid State Plan (Attachment 4.19-D).
CY 2026 Rates Policy Letter
2026 Rates (Updated 10/31/2025)
Effective 1/1/2026 through 12/31/2026
| Service Type | Value Code | Value Code Amount | Revenue Code | Per Diem |
|---|---|---|---|---|
| Rehab Therapy | 24 | 83 | 0199 | $93.34 |
| Vent Weaning | 24 | 84 | 0199 | $87.01 |
| Ventilator | 24 | 85 | 0190 | $1,552.61 |
| Non-Ventilator | 24 | 86 | 0190 | $1,429.67 |
Bed Hold/Leave of Absence Rates – Effective 1/1/2026 through 12/31/2026
| Service Type | Value Code | Value Code Amount | Revenue Code | Bed Hold/Leave of Absence Per Diem |
|---|---|---|---|---|
| Ventilator | 24 | 87 | 0185 | $1,542.66 |
| Non-Ventilator | 24 | 88 | 0185 | $1,419.72 |
| Ventilator | 24 | 89 | 0180 | $1,542.66 |
| Non-Ventilator | 24 | 90 | 0180 | $1,419.72 |
Notes:
- The 2026 Calendar Year bed hold amount is $9.95.
2025 Rates (Updated 3/4/2025)
Effective 1/1/2025 through 12/31/2025
| Service Type | Value Code | Value Code Amount | Revenue Code | Per Diem |
|---|---|---|---|---|
| Rehab Therapy | 24 | 83 | 0199 | $89.37 |
| Vent Weaning | 24 | 84 | 0199 | $83.31 |
| Ventilator | 24 | 85 | 0190 | $1,461.99 |
| Non-Ventilator | 24 | 86 | 0190 | $1,342.66 |
Bed Hold/Leave of Absence Rates – Effective 1/1/2025 through 12/31/2025
| Service Type | Value Code | Value Code Amount | Revenue Code | Bed Hold/Leave of Absense Per Diem |
|---|---|---|---|---|
| Ventilator | 24 | 87 | 0185 | $1,452.22 |
| Non-Ventilator | 24 | 88 | 0185 | $1,332.89 |
| Ventilator | 24 | 89 | 0180 | $1,452.22 |
| Non-Ventilator | 24 | 90 | 0180 | $1,332.89 |
Notes:
- The 2025 Calendar Year bed hold amount is $9.77.
2024 Rates – Updated in Accordance with the LTC Claim Form and Code Conversion Data Elements
Effective 2/1/2024 through 12/31/2024
| Service Type | Value Code | Value Code Amount | Revenue Code | Per Diem |
|---|---|---|---|---|
| Rehab Therapy | 24 | 83 | 0199 | $85.64 |
| Vent Weaning | 24 | 84 | 0199 | $79.84 |
| Ventilator | 24 | 85 | 0190 | $1,375.00 |
| Non-Ventilator | 24 | 86 | 0190 | $1,259.58 |
Bed Hold/Leave of Absence Rates – Effective 2/1/2024 through 12/31/2024
| Service Type | Value Code | Value Code Amount | Revenue Code | Bed Hold/Leave of Absense Per Diem |
|---|---|---|---|---|
| Ventilator | 24 | 87 | 0185 | $1,365.48 |
| Non-Ventilator | 24 | 88 | 0185 | $1,250.06 |
| Ventilator | 24 | 89 | 0180 | $1,365.48 |
| Non-Ventilator | 24 | 90 | 0180 | $1,250.06 |
Notes:
For more information, please visit LTC Claim Form and Code Conversion webpage.
2024 Rates – Local Accommodation Codes
Effective 1/1/2024 through 1/31/2024
| Service Type | Accommodation Code | Per Diem | Bed Hold / Leave of Absence Accommodation Code | Bed Hold / Leave of AbsencePer Diem |
|---|---|---|---|---|
| Rehab Therapy | 83 | $85.64 | n/a | n/a |
| Vent Weaning | 84 | $79.84 | n/a | n/a |
| Ventilator | 85 | $1,375.00 | 87/89 | $1,365.48 |
| Non-Ventilator | 86 | $1,259.58 | 88/90 | $1,250.06 |
Helpful Links
Freestanding Skilled Nursing Facilities and Subacute Units (ca.gov)
Contact Us
Please send questions regarding DP/PSA rates to LTCReimbursement@dhcs.ca.gov