Advisory Board December 1, 2025
CMS has finalized the Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System rule for 2026, which includes a modest payment increase, new price transparency policies, and more.
Inside the 2026 OPPS/ASC final rule
Under the final OPPS/ASC rule, outpatient healthcare facilities and ASCs will receive a net 2.6% payment increase in 2026 compared to 2025. This increase includes a 3.3% market basket update, along with a -0.7 percentage point productivity adjustment. The final payment increase of 2.6% is slightly higher than the 2.4% initially proposed in July.
Aside from the payment updates, CMS also finalized several new policy changes in the rule.
Starting in 2026, CMS will begin phasing out the “inpatient only list,” which...
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