Adds a new “high acuity” exception so some long‑term care hospital stays are not paid under Medicare’s lower site‑neutral rates. If a patient’s discharge is assigned to a long‑term care diagnosis group with a relative weight of 0.8 or higher, Medicare will pay the standard long‑term care hospital rate instead of the lower site‑neutral rate.

This applies to discharges on or after October 1, 2026. It is a targeted payment policy change intended to protect higher‑acuity long‑term care hospital cases from reduced reimbursement.