Freestanding Pediatric Subacute
Freestanding Pediatric Subacute (FS/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 23-0028.
CY 2026 Rates
CY 2026 Rates Studies Public Review Draft
The above document contains preliminary modeling FS/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). Please see the disclaimer included in the document. This draft does not update the Medi-Cal rate on file and is not intended for payment purposes or any other use. Final CY 2026 rates may materially differ from this modeling based on changes on corrections to underlying data, changes necessary to obtain federal approval, and other changes deemed appropriate in DHCS's sole discretion. DHCS requests any comments or feedback no later than October 17, 2025. For any questions or comments, please email
LTCReimbursement@dhcs.ca.gov with the subject line “CY 2026 Rates Public Review Draft”.
2025 Rates (Updated 3/4/2025)
Effective 1/1/2025 through 12/31/2025
Rehab Therapy
| 24
| 97
| 0199
| $94.23
|
Vent Weaning
| 24
| 98
| 0199
| $87.86
|
Ventilator
| 24
| 91
| 0190
| $1,353.10
|
Non-Ventilator
| 24
| 92
| 0190
| $1,234.74
|
Bed Hold/Leave of Absence Rates - Effective 1/1/2025 through 12/31/2025
Ventilator
| 24
| 93
| 0185
| $1,343.33
|
Non-Ventilator
| 24
| 94
| 0185
| $1,224.97
|
Ventilator
| 24
| 95
| 0180
| $1,343.33
|
Non-Ventilator
| 24
| 96
| 0180
| $1,224.97
|
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
Rehab Therapy
| 24
| 97
| 0199
| $90.30
|
Vent Weaning
| 24
| 98
| 0199
| $84.20
|
Ventilator
| 24
| 91
| 0190
| $1,316.13
|
Non-Ventilator
| 24
| 92
| 0190
| $1,198.56
|
Bed Hold/Leave of Absence Rates - Effective 2/1/2024 through 12/31/2024
Ventilator
| 24
| 93
| 0185
| $1,306.61
|
Non-Ventilator
| 24
| 94
| 0185
| $1,189.04
|
Ventilator
| 24
| 95
| 0180
| $1,306.61
|
Non-Ventilator
| 24
| 96
| 0180
| $1,189.04
|
Notes:
2024 Rates - Local Accommodation Codes
Effective 1/1/2024 through 1/31/2024
Rehab Therapy
| 97
| $90.30
| n/a
| n/a
|
Vent Weaning
| 98
| $84.20
| n/a
| n/a
|
Ventilator
| 91
| $1,316.13
| 93/95
| $1,306.61
|
Non-Ventilator
| 92
| $1,198.56
| 94/96 | $1,189.04
|
Helpful Links
Freestanding Skilled Nursing Facilities and Subacute Units (ca.gov)
Contact Us
Please send questions regarding FS/PSA rates to LTCReimbursement@dhcs.ca.gov
