U.S. flag

An official website of the United States government

Managed Long-Term Services and Supports

Managed Long Term Services and Supports (MLTSS) refers to the delivery of long term services and supports through capitated Medicaid managed care programs. Increasing numbers of states are using MLTSS as a strategy for expanding home- and community-based services, promoting community inclusion, ensuring quality, and increasing efficiency.

Medicaid MLTSS programs can be operated under multiple federal Medicaid managed care authorities at the discretion of the state and as approved by CMS, including 1915a, 1915b, and 1115. There are requirements and limitations related to each authority, and managed care authority can be combined with other home and community based authorities to operate the MLTSS program (as with a concurrent 1915(b)/1915(c), for example).

In September 2014, CMS initiated a national, cross-state evaluation of MLTSS. The MLTSS evaluation is one component of a larger evaluation designed to track and evaluate several different types of Medicaid section 1115 demonstration waivers. However, the MLTSS component of the evaluation is not limited to programs using section 1115 demonstration authority. Learn more about the national, cross-state evaluation.

CMS developed a number of technical assistance tools for states, and other stakeholders to enhance the availability and quality of MLTSS. These tools include:

Assessment and Person-Centered Planning Quality Measures

Falls Risk Screening Quality Measure

LTSS Rebalancing and Utilization Quality Measures

The Value Sets for MLTSS and FFS LTSS Measures 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 both versions of the LTSS-4, LTSS-6, LTSS-7, and LTSS-8 measures.

The LTSS Risk Adjustment Tables Workbook includes the coefficients (model weights) for each risk factor and the mapping of the diagnosis codes to the risk factors.

Additional resources for MLTSS programs are available in an Informational Bulletin released on May 21, 2013.

*For accessibility issues with accessing the MLTSS tool email Medicaid.gov@cms.hhs.gov for assistance.