Becker's Healthcare November 3, 2025
CMS is advancing a major step toward site-neutral payment reform in its proposed 2026 Hospital Outpatient Prospective Payment System rule, a move that could redefine how hospitals and ASCs collaborate.
The proposal, which closed for public comment Sept. 15, aims to reduce long-standing disparities in Medicare reimbursement between hospitals and physician offices. CMS estimates that hospitals currently receive about 60% higher payments than physician offices for similar services due to differences in how professional and facility fees are calculated.
Site-neutral payment policies, which would require Medicare to pay the same rate for a service regardless of where it’s delivered, have been a policy focus for years. Lawmakers argue that the current system encourages hospitals to acquire physician practices to capture...
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