Long-Term Services and Supports (LTSS) Quality Measures

CMS is the measure steward for 15 nationally standardized LTSS quality measures including managed care and fee-for service (FFS) quality measures delivered by states through their Medicaid programs. The MLTSS and FFS LTSS measures are aligned pairs, collectively referred to as LTSS quality measures, with unique technical specifications focused on MLTSS and FFS delivery systems. The LTSS quality measures are can be grouped into three categories of quality measures: assessment and care planning, falls risk assessment and rebalancing and utilization.

The LTSS Quality Measures Technical Specifications and Resource Manual contains the CMS LTSS measures, including eight MLTSS and seven FFS LTSS quality measures for states and Medicaid managed care programs.  With the 2024 manual update, states with hybrid LTSS programs, delivered via FFS and managed care delivery systems, should utilize both, the FFS LTSS and MLTSS measures specifications in the manual to best evaluate performance for their state’s LTSS programs.

The Medicaid MLTSS-4 Value Sets include the lists of Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS), International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10), Systematized Nomenclature of Medicine (SNOMED®), and Uniform Billing (UB) codes used to calculate the following MLTSS and FFS LTSS measure:

• LTSS-4 LTSS Reassessment and Person-Centered Plan Update After Inpatient Discharge

The Medicaid MLTSS-6, MLTSS-7, and MLTSS-8 Value Sets include the third party medical and billing codes to calculate the following MLTSS and FFS LTSS measures:

• MLTSS-6: Managed LTSS Admission to a Facility from the Community 
• MLTSS-7, CBE 3457: Managed LTSS Minimizing Facility Length of Stay
• MLTSS-8: Managed LTSS Successful Transition After Long-Term Facility Stay
• FFS LTSS-6: Admission to a Facility from the Community Among Medicaid HCBS Participants
• FFS LTSS-7: FFS LTSS Minimizing Facility Length of State
• FFS LTSS-8: FFS LTSS Successful Transition After Long-Term Facility Stay

Assessment and Care Planning Quality Measures

• Comprehensive Assessment and Update (MLTSS-1 and FFS LTSS-1; CMIT Measure ID #960)
• Comprehensive Person-Centered Plan and Update (MLTSS-2 and FFS LTSS-2; CMIT Measure ID #961)
• Shared Person-Centered Plan with Primary Care Provider (MLTSS-3 and FFS LTSS-3; CMIT Measure ID #963)
• Reassessment and Person-Centered Plan after Inpatient Discharge (MLTSS-4 and FFS LTSS-4; CMIT Measure ID #962)

Falls Risk Screening Quality Measure

• Falls Risk Screening, Assessment, and Plan of Care to Prevent Future Falls (MLTSS-5; CMIT Measure ID #1255)

LTSS Rebalancing and Utilization Quality Measures

• Admission to a Facility from the Community (MLTSS-6 and FFS LTSS-6; CMIT Measure ID #20)
• Minimizing Facility Length of Stay (MLTSS-7 and FFS LTSS-7; CMIT Measure ID #968)
• Successful Transition after Long-Term Facility Stay (MLTSS-8 and FFS LTSS-8; CMIT Measure ID #414)

For LTSS Quality Measures technical assistance, please email MLTSSMeasures@cms.hhs.gov with questions and requests for support.

Additional information is available on LTSS Measures.

[1]The CMIT is the repository for measures which CMS uses to promote healthcare quality and quality improvement. The CMIT is organized by measure ID number and contains measure information, including title, numerator, denominator, exclusions, various identifiers, type, status, usage by program, and meaningful measure areas.